According to the Office of Dietary Supplements at the National Institutes of Health, the average adult age 19 or older needs 2.4 mcg of B12 daily (or 2.6 mcg for pregnant women and 2.8 mcg for women who are breastfeeding)
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and patients with pernicious anemia who have optic neuropathy COBALAMIN (Vitamin B12) Deficiency Causes Vegetarians (dietary deficiency) Older adults: atrophic gastritis affects 10% 30% and leads to decrease in hydrochloric acid secretion in the stomach and decreased absorption of Vitamin B12 The liver can store up to six years worth of Vitamin B12 so deficiencies are rare Effects of deficiency Megaloblastic anaemia (pernicious anaemia) Progressive demyelination of nerve cells Elevation in levels of circulating homocysteine that leads to production of defective collagen and elastin with a negative impact on arteries, bone and skin Deep vein thrombosis is associated with homocysteinemia that causes the activation of the intrinsic coagulation cascade Symptoms include fatigue, weakness, constipation, loss of appetite and weight loss Numbness, tingling of the feet imbalance, depression, confusion, dementia, poor memory and glossitis

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This conversion process can be less efficient in individuals with certain genetic mutations or metabolic issues, making Methylcobalamin a more effective option for these populations
Early body composition changes, such as reduced waist circumference or modest fat loss, often become apparent by weeks 2-4