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Up to 40% of thyroid patients are vitamin B12 deficient, and the symptoms of B12 deficiency (fatigue, brain fog, numbness) closely mimic hypothyroidism, making it easy to miss

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CSF levels of 5-MTHF and tetrahydrobiopterin are lower than normal, while serum levels of folate, dihydrobiopterin, and homocysteine remain within the normal range

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Pernicious Anemia : This is an autoimmune disorder in which the body's immune system attacks and destroys the cells that produce intrinsic factors, leading to vitamin B12 deficiency

Alternatives to injections: when oral therapy works Oral vitamin B12 is an effective alternative in many situations