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Most available data comes from animal models and preclinical studies

If you dont get enough B12 in your diet or through supplementation, you may develop one or more of the following symptoms [4]: - Mild fatigue during exercise or daily activities - Heart palpitations - Skin paleness or hyperpigmentation - Glossitis (tongue inflammation) - Neurological symptoms such as loss of reflexes, loss of proprioception (knowing where your limbs are without looking at them), forgetfulness Signs that healthcare providers use to detect a B12 deficiency include [4]: - Megaloblastic anemia (abnormally large and nucleated red blood cells) - Abnormal blood work, including decreased levels of haptoglobin

Additional synthesis can provide improved memory (in certain forms of dementia), increased concentration (ensuring attention), neuroprotective effects (in neurodegenerative diseases), and stabilization of mood

Toxins , 5(4), 605-617

Its hard to separate what the supplement did from what the lifestyle changes did