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People with low B12 levels often report: Excessive daytime sleepiness Fatigue despite adequate sleep duration Various neurological symptoms that may indirectly affect sleep quality Correcting B12 deficiency typically improves these symptoms over several weeks to months, as the body's stores are replenished and metabolic function normalises

Conflict of Interest The authors have declared that no conflict of interest exists

Consider a patient receiving rituximab infusion for rheumatoid arthritis in an outpatient infusion center

This product should not be used as a substitute for a varied diet

May require surgical evaluation