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Fatal hypokalemia may occur when severe megaloblastic anemia is treated intensively with vitamin B12, as a result of increased erythrocyte potassium requirements
Fatigue, lightheadedness, and overall weakness are the most common symptoms of low B12
As a cofactor, cobalamins are essential for two cellular reactions: the mitochondrial methylmalonyl-CoA mutase conversion of methylmalonic acid (MMA) to succinate, which links lipid and carbohydrate metabolism, and the activation of methionine synthase, which is the rate-limiting step in the synthesis of methionine from homocysteine and 5-methyltetrahydrofolate
Yet a single milligram value can serve different goals: 1.0 mg is a modest weight-loss dose but the proven kidney dose in type 2 diabetes
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