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Your doctor usually diagnoses B12-deficiency anemia in conjunction with abnormal blood testing results

doi:10.1093/ajcn/85.2.460

Sleep improvements are typically the first effect patients notice, followed by better energy and overall recovery as the cycle progresses

In the case of pronounced absorption disorders, for example as a result of gastritis or after removal of the small intestine, in Crohn's disease, diverticulosis and the so-called blind-loop syndrome, there is a gradual decrease in the vitamin B12 store in the liver, which can turn into a manifest vitamin B12 deficiency

But then, constipation and the associated leaky gut often lead to small intestinal bacterial overgrowth