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Severe deficiency: For severe cases, more doses or injections might be needed, even if there are neurological symptoms

This can happen as the result of a problem known as functional vitamin B12 deficiency, where there's a problem with the proteins that help transport vitamin B12 between cells

You can find genetic testing with various companies such as 23andme.com Its estimated that those with one mutation (heterozygous) decrease their ability to methylate by 30% and those with two mutations (homozygous) decrease their ability to methylate by 70%, making it virtually impossible to get adequate B12 from diet alone (19)