vegetarians should get b12 injections Benefits Of B-12 For Vegans & The Truth About B12 Injections:

Many patients receive weekly or biweekly injections to maintain optimal energy levels

Vegans have no reliable dietary b12 sources unless they consume fortified foods or supplements

Signs of the disease often include: Constitutional symptoms: fatigue, lethargy, loss of appetite, and weight loss Neurological changes: headaches, confusion, difficulty focusing, memory loss, cognitive decline, numbness, and balance issues Psychiatric effects: emotional instability, depression, personality changes, psychosis Otolaryngologic symptoms: loss or change in the sense of taste, inflammation of the tongue Cardiopulmonary indications: palpitations, difficulty breathing Gastrointestinal problems: indigestion, diarrhea, reduced appetite Patients with advanced pernicious anemia may also have noticeable physical characteristics such as pale or yellowing skin, dry skin, tender tongue, and rapid heart rate

Facts and recommendations about total homocysteine determinations: an expert opinion