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This includes starting with big doses, then keeping up with smaller ones

2021. NNMT inhibition reduces obesity and diabetes risk

In addition, B12 deficiency-associated fatigue is often accompanied by other symptoms such as numbness and tingling, cognitive impairment (memory and concentration problems), mood swings (depression), skin changes (pale skin), shortness of breath, or fast heart rate

The ability to shuttle between the +1, +2, and +3 oxidation states is responsible for the versatile chemistry of vitamin B 12 , allowing it to serve as a donor of deoxyadenosyl radical (radical alkyl source) and as a methyl cation equivalent (electrophilic alkyl source)