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Exhaustion: Fatigue may result from megaloblastic anemia caused by a vitamin B12 deficiency

Some medications such as anticonvulsants and proton pump inhibitors, can also increase the likelihood of B12 deficiency through varied mechanisms

Heather Smith-Fernandez: Improving the condition of our mitochondria and improving efficient output of cellular energy has widespread effects, and in some cases, these effects are palpable (we actually feel more energy, more focus, less pain, more endurance)

1 H NMR (400 MHz, DMSO-d 6 ) 9.45 (br, 1H), 8.87 (br, 1H), 8.34 (d, J=9.2 Hz, 1H), 8.01 (d, J=8.8 Hz, 1H), 7.98 (d, J=8.8 Hz, 1H), 7.87 (dd, J=8.4, 7.6 Hz, 1H), 7.57 (dd, J=7.6, 7.6 Hz, 1H), 7.17 (d, J=9.2 Hz, 1H), 3.87 (s, 3H)

When activated by catecholamines like norepinephrine, they inhibit adenylyl cyclase, reducing cAMP and preventing fat breakdown

injections are only considered if oral therapy fails or compliance is problematic