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The British Obesity and Metabolic society recommend intramuscular injection of vitamin B 12 should be taken every three weeks in RYGB and BPD/DS patients, since the deficiency of B 12 still exists in the presence of higher doses of the oral supplement [120]

However, complete loss of TGF- signaling in T cells inhibits CD8 + T cell development, 107 likely due to the requirement for TGF- to induce the IL-7 receptor on CD8 + T cells

(10) Research suggests that deficiencies of vitamin B12 can decrease energy and exercise tolerance, along with causing fatigue and shortness of breath

Tak YJ, Shin DK, Kim AH, Kim JI, Lee YL, Ko H-C, et al

Imbalances in this ratio have been linked to various health conditions, including cardiovascular disease, inflammation, and mental health disorders