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Next link about causes is from a Dutch B12 website b12-institute.nl/en/causes-

This article gives an overview of the development and characteristics of vitamin B12 deficiency symptoms

Some participants achieved weight loss of approximately 24% of body weight at 48 weeks approaching levels reported with some bariatric surgical procedures, though no direct head-to-head comparisons have been conducted and long-term durability beyond the trial period remains unknown

Moreover, some of these studies used dietary intake assessment methods to measure micronutrient status

That makes them far more effective than oral supplements, especially for patients managing deficiencies, chronic fatigue, or general low energy

By matching caloric intake to resting energy expenditure, Naltrexone can reduce overall appetite without causing the typical metabolic damage associated with chronic appetite suppression