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Some practitioners state that you do not need a blood test prior to starting on a programme of vitamin B12 injections stating that symptoms of feeling run down are enough and with the lack of overdose risk, you have nothing to lose

The prevalence of cobalamin deficiency among vegetarians assessed by serum vitamin B12: a review of literature. European Journal of Clinical Nutrition 68(5) (2014): 541548

B12 is a required cofactor for DNA synthesis without enough of it, cells can't replicate efficiently

alternate supplement formulations of vitamin B 12 , such as methylcobalamin and hydroxycobalamin, have been suggested for this patient population