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Symptoms of vitamin B12 deficiency may include any or all of the following: Chronic fatigue (4) or low energy (despite getting enough sleep) Shortness of Breath Macrocytic anemia (5) High MCV (mean corpuscular volume on CBC analysis) Neurological changes that can mimic dementia (6) Depression (7), anxiety, and other mood disorders Difficulty with concentration (8) Brain fog Skin changes like hyperpigmentation (9), vitiligo, or angular stomatitis Hair changes (including hair loss (10)) Perhaps you can relate to one or more of these symptoms noted above

10.1146/annurev-biophys-052118-115517

AUA categorizes body of evidence strength as Grade A (well-conducted RCTs or exceptionally strong observational studies), Grade B (RCTs with some weaknesses of procedure or generalizability or generally strong observational studies), or Grade C (observational studies that are inconsistent, have small sample sizes, or have other problems that potentially confound interpretation of data)

Each botulinum toxin type A product has its own reconstitution guidelines that professionals must follow carefully