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Finasteride reduces DHT (root cause)

Additionally, Sun et al

Nutritional deficiency is caused by a lack of the vitamin in the diet, whereas acquired deficiency occurs when the intestinal absorption of the vitamin is interfered with by diseases and conditions such as pernicious anemia (an autoimmune disorder affecting intrinsic factor protein produced by gastric parietal cells), chronic atrophic gastritis, Crohn's and celiac diseases, gastric bypass surgery, and medications such as metformin, gastric acid secretion blockers (i.e., proton-pump inhibitors and H2-receptor antagonists), and others (2, 3)

How to Tell if Treatment Is Effective Improvement is sometimes gradual and easy to miss day to day, so we suggest keeping a simple symptom log

You can also consult your doctor to establish an appropriate dose if its determined that you dont get enough B12 from food sources