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The Active B12 Test Most Labs Dont Do Holotranscobalamin is the fraction of B12 that your cells can actually grab and use

If sleep is disrupted by hot flashes and heart palpitations are worse due to lack of sleep, hormone replacement might be the answer

Only 12% of an oral crystalline dose of non-protein bound vitamin B12 as occurs in fortified foods and supplements is absorbed by simple passive diffusion throughout the length of the gastrointestinal tract (Doets et al., 2013)

Vitamin B-12 deficiency has many identifiable causes, including autoimmune and other gastrointestinal malabsorption disorders, dietary deficiency, and congenital defects in genes that are involved in vitamin B-12 trafficking and functions