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[Abstract]2023 Jul;39(7):699-709

The medications most commonly associated with B12 deficiencies include metformin (diabetes), antacids, anti-ulcers, blood pressure, cholesterol meds, and birth control pills (12, 13)

Jankowska EA, Kasztura M, Sokolski M, Bronisz M, Nawrocka S, Olekowska-Florek W, et al

I mention the bottom as I imagine it would hurt less

The Lancet Neurology Conference Preclinical neurodegenerative disease: towards prevention and early diagnosis Oct 19-21, 2016, Park Plaza Riverbank, London, UK

while some patients report subtle shifts in energy within a few weeks, it typically takes 2 to 3 months of daily supplementation to sufficiently replenish deep intracellular nutrient deficits and observe meaningful changes in baseline fatigue