Complement to NAD &GLP-1 B12 supports many of the same pathways energy, metabolism, recovery so it can synergize with NAD+, GLP-1 agents, and your nutrition regimen
Modern Nutrition in Health and Disease
Pale or Bluish Skin : Skin may also be cold or clammy to the touch

This, in turn, has led to delayed diagnosis, notably in people presenting solely with neurological symptoms.68232425 However, in many people, neurological and neuropsychological or cognitive symptoms (box 1, fig 1) are the main presenting symptoms.23 Anaemia is present in fewer than 20% of people with B 12 deficiency.26 Cobalamin analogue formation maybe related to more prominent neurological manifestations.30 Frequently reported signs and symptoms of B 12 deficiency92326272829 Brain function: Brain fog, memory problems, cognitive impairment, insomnia, headaches (especially migraine), behavioural changes, learning problems, nominal aphasia Mood: Mood swings, irritability, depression, anxiety, hallucinations, delusions, psychosis Sensory: Peripheral paraesthesia (pins and needles), numbness, neuropathic pains, poor balance, reduced vibration sense or proprioception (joint position sense), tinnitus, ataxia, taste impairment, sometimes myelopathy Constitutional: Fatigue, anaemia (either macrocytic, or normocytic when also iron deficient or associated with thalassaemia minor), other cytopenia, abdominal complaints, malabsorption, failure to thrive, weight loss, diarrhoea, hyperpigmentation, glossitis, (aphthous) stomatitis, infertility, urinary tract infections Motor: Muscle weakness, altered reflexes (increased in degeneration of the spinal cord, reduced when peripheral neuropathy dominates), spasticity, seizures, cardiomyopathy Autonomic: Urinary and/or faecal incontinence, postural hypotension or dizziness, erectile dysfunction Diagnosing B 12 deficiency can be challenging because no single specific measurement exists to reliably diagnose or refute the presence of B 12 deficiency11122627 (box 2)

Vitamin B12 Signs of Vitamin B12 deficiency: A person with vitamin B12 deficiency has signs such as anemia, low energy, craving for meat or often finds himself bruising easily