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These include: Pernicious Anemia: An autoimmune disease that stops the stomach from making a protein needed for B12 absorption

Both these tests can be unreliable

The organ that is most affected by B12 deficiency is the nervous system and brain

4,5 Dietary insufficiency, pernicious anemia (i.e., an autoimmune process that reduces available intrinsic factor and subsequent absorption of vitamin B 12 1,2,6,7 ), and long-term use of metformin or acid-suppressing medications have been implicated in B 12 deficiency

Another study published in the Journal of Psychopharmacology found that B12 supplements improved mood and reduced symptoms of depression in individuals with depression

I've since bought up-to-date ampoules and, having various symptoms which may be related to low levels, I've decided to do alt days for a couple of weeks, then back to 2-3 monthly