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Normal vitamin B12 levels do not change with age, so theres no need to look for a different cutoff as people get older

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Arch Biochem Biophys 433:166175 Banerjee R, Zou CG (2005) Redox regulation and reaction mechanism of human cystathionine-beta-synthase: a PLP-dependent hemesensor protein

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Energy metabolism Helps convert food into energy Causes of Vitamin B12 Deficiency Poor dietary intake (especially vegetarians/vegans) Pernicious Anemia Gastric surgery (loss of intrinsic factor) Malabsorption disorders Long-term use of some medications (e.g., metformin) Signs and Symptoms of Deficiency Fatigue and weakness Pale skin Shortness of breath Numbness or tingling in hands and feet Difficulty walking Memory problems or confusion Smooth, red tongue (glossitis) Complications Megaloblastic Anemia Peripheral Neuropathy Cognitive impairment if untreated Diagnosis Blood test for serum Vitamin B12 level Complete blood count (shows macrocytic anemia) Elevated homocysteine or methylmalonic acid Treatment Vitamin B12 supplements Vitamin B12 injections for severe deficiency or malabsorption Dietary improvement Vitamin B12 deficiency can cause both anemia and nerve damage, so early diagnosis and treatment are important

When stored at room temperature up to 86F (30C), the pens can be used for up to 28 days or until their expiration date, whichever comes sooner