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These include chronic fatigue, anemia, and low energy levels

Preventing pernicious anaemia can be challenging since an autoimmune process or genetic factors often cause it (Pernicious Anemia: MedlinePlus Medical Encyclopedia, n.d.)

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References (1) Pissios P

Vitamin B12 Warnings Patients who have early Leber's disease (LHON) a hereditary disease that causes optic nerve atrophy have been found to suffer severe and swift optic atrophy when treated with vitamin B12

Periodic re-assessment is the difference between an organized recovery and a vague "I think it's getting better" loop