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The major functions of vitamin B12 are the synthesis of red blood cells, the upkeep of a healthy neurological system, and the metabolism of fats and proteins

At minimum, check metabolic panels, liver function, lipid profiles, and fasting glucose before starting and every 8-12 weeks during combination therapy

"but I do find it weird that my B12 is nonexistent and yet my RBC, MCV, and MCH are normal." Low B12 can lead to enlarged red blood cells (macrocytosis)

However, things may be changing in the research world

B12 shots are generally considered safe and may be recommended if you have a lab-confirmed deficiency

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