Many diseases, including diabetes, have been associated with damage and loss of small unmyelinated or lightly myelinated fibers of the peripheral sensory and autonomic nervous system, termed small fiber neuropathy (SFN)
And theyre not alone
This "paradoxical response" (where treatment temporarily makes symptoms worse) includes: Numbness and tingling Shooting pains Joint pain Increased sensitivity Temporary inflammation (swelling and irritation) While these symptoms generally indicate that treatment is working (as nerves begin to repair themselves), they can be distressing for patients and may require additional treatment for comfort
For most healthy individuals, maintaining adequate intake through a balanced diet or a high-quality dietary supplement is sufficient to support red blood cell health, nerve function, and energy levels
Proton pump inhibitors (acid blockers) and over-the-counter non-steroidal anti-inflammatory agents can change the environment of the GI tract predisposing to nutrient deficiencies Unfortunately, that isnt an exhaustive list, but it does give you a pretty good idea of why you should be concerned about your vitamin B12 levels