Common examples include fatigue or low energy with normal blood results, brain fog or reduced concentration without confirmed vitamin B12 deficiency, stress-related exhaustion or burnout, increased metabolic demand such as during illness recovery, high workload, or intense training, restrictive or inconsistent dietary intake, or suspected poor oral absorption despite normal serum levels
- when there is risk of torsades de pointes, for example in patients with prolonged QT, concomitant administration of other medications that produce torsades de pointes (amiodarone, quinidine, bepridil, IV erythromycin, halofrantine, pentamidine, sparfloxacin, sultopride, vincamine, betrilio, disopyramide, sotalol, etc)
B12 shots can cause side effects, some of which are serious
As BAC levels increase, risks escalate to include slurred speech, impaired coordination, and increased accident susceptibility
So it may be that the liver has to work extra hard to detoxify the body when its low 0on B12, even when there's no liver damage
Limited published evidence