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If your deficiency is related to your diet, you may be advised to take vitamin B12 tablets or an injection twice a year

Pick the right kind of vitamin B12 There are two most common forms of vitamin B12: cyanocobalamin and methylcobalamin

However, when liver cells become infiltrated with fat or damaged by inflammation (as in NASH), their metabolic efficiency may decline

Kidney Dysfunction: While the kidneys do not directly excrete vitamin B12 efficiently, impaired renal function may lead to elevated serum B12 levels by reducing the clearance of B12-binding proteins or altering their metabolism, thereby contributing to B12 accumulation 8

Vitamin B12 supplements and fortified foods contain B12 derived from microorganisms, such as yeasts and bacteria