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The higher the dose, the less is absorbed. At low or moderate doses, also called physiological doses, which are those we would get through food (although we could also include B12 provided by fortified foods or supplementation in very small amounts), absorption depends on the intrinsic factor secreted and the intestinal receptors of the Castle complex, which regulate absorption

Regular check-ins let you discuss blood test results and adjust your care plan if needed

It is also important to be aware of symptoms that may suggest either worsening B12 deficiency or poorly controlled blood glucose, and to seek prompt medical advice if you experience: Persistent fatigue, breathlessness, or pallor (possible anaemia) Tingling, numbness, or weakness in the hands or feet (possible B12-related neuropathy) Unsteadiness when walking, or changes in memory or thinking (possible signs of more severe B12 deficiency requiring prompt assessment) Increased thirst, frequent urination, or unexplained weight loss (possible hyperglycaemia) If you think you may be experiencing a side effect from a medicine for example, symptoms of B12 deficiency that you believe may be related to metformin you or your healthcare professional can report this via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk

Note that these are side effects that healthy people may experience when taking large doses of these vitamins