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If youve been doing the right things and still feel stuck, its normal to look for support that doesnt feel extreme

Wilson's disease causes copper accumulation due to impaired excretion

Self-administered B12 shots are generally recommended for individuals: whose bloodwork has documented low B12 levels Patients with pernicious anemia or a lack of intrinsic factor Individuals with Crohn's disease, celiac disease, or post-bariatric surgery malabsorption Vegans and strict vegetarians are unable to correct the deficiency through diet Older adults whose stomach acid production has declined with age Anyone on long-term metformin or proton pump inhibitors Across most of the U.S., injectable B12 is not sold over the counter a clinician has to write the script before a pharmacy can dispense it

The average diet supplies about 5 to 15 mcg/day of Vitamin B12 in a protein-bound form that is available for absorption after normal digestion

It binds to skeletal muscle cells and activates AMPK, the enzyme responsible for switching cellular metabolism from anabolic (storage) to catabolic (burning) states

But after gastric bypass, making less intrinsic factor means less B12 gets absorbed