Reasons for fatigue Fatigue stems from physical or mental factors, including things like: Metabolic conditions such as diabetes, kidney disease, Cushing syndrome, and thyroid conditions Mental health issues such as depression, stress, eating disorders, anxiety, and burnout Cardiovascular conditions affecting blood flow, such as arrhythmias, heart disease, and heart failure Medications such as antidepressants, antihistamines, steroids, statins, and sedatives Sleep problems due to insomnia, narcolepsy, jet lag, and sleep apnea Chemical imbalances due to too little or too much of various essential nutrients, vitamins, and minerals Facts about B12 deficiency Also referred to as cobalamin deficiency and named after the scientific term for this water-soluble nutrient, a B12 deficiency can result from low dietary intake or from your body not absorbing the vitamin properly

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Possible immune or systemic effects, but poorly understood
Common protocols suggest 6 to 12 weeks on the compound followed by a break period of roughly half that duration
[51] Diagnosis [edit] According to one review: "At present, no 'gold standard' test exists for the diagnosis of vitamin B 12 deficiency and as a consequence the diagnosis requires consideration of both the clinical state of the patient and the results of investigations." [52] The vitamin deficiency is typically suspected when a routine complete blood count shows anemia with an elevated mean corpuscular volume (MCV)