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Annual blood tests including serum B12, full blood count, ferritin, vitamin D, and folate are recommended as a minimum for long-term post-bariatric monitoring

Signs and symptoms of vitamin B12 deficiency can include fatigue, pale skin, headaches, shortness of breath, fast heartbeat, gastrointestinal issues, mouth inflammation, paresthesias (abnormal sensations), decreased cognitive ability, depression, muscle weakness, imbalance and incoordination, vision problems, and erectile dysfunction

Its often called The Forgotten Disease

This occurs not only outside the cell, but also inside the cell ( CD38 Is Involved in Nerve Injury and Protection of Macrophages After facial nerve transection in Cd38 knockout mice, axonal degeneration and demyelination were delayed, and macrophage aggregation decreased