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15 In contrast, falsely normal levels may be seen in patients with liver disease, myeloproliferative disorders, or renal disease

A vitamin B12 deficiency can cause extreme fatigue, among other symptoms, and leave individuals feeling weak and foggy

Another class of gastric acid inhibitors known as histamine 2 (H 2 )-receptor antagonists (e.g., cimetidine, famotidine, and ranitidine), often used to treat peptic ulcer disease, has also been found to decrease the absorption of vitamin B 12 from food

Always follow up as scheduled so your provider can make that decision with you

After receiving a B12 shot, avoid heavy lifting or intense physical activity for the first 24 hours to minimize soreness at the injection site