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Why Deficiency Matters Even mild deficiency can cause wide-ranging symptoms: Persistent fatigue or low energy Brain fog, mood changes, or poor concentration Tingling or numbness in hands and feet Pale skin or shortness of breath Reduced immune function These occur because B12 is critical for oxygen transport and nerve conduction

However, most products are sold on a weight basis, so removing water also reduces the weight of the product and results in lost revenue

We also note that this policy does not undermine beneficiary choice in any way because beneficiaries may continue to receive care at providers of their choosing

Trends Mol Med 23:899916

This discrepancy may reflect the sensitivity difference between the two measurement methods