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As one person put it: "Very common for people on a restricted calorie diet and losing weight." - FatGuy48 Other factors mentioned in the textfile include: reduced intrinsic factor in some users the combined effect of medications like metformin pre-existing low levels that worsen during weight loss Regardless of the pathway, the pattern is clear: B12 can drop quickly during significant appetite reduction, and deficiency tends to worsen quietly until symptoms demand attention

Its important for patients to understand the difference between a doctor who is non-participating versus a doctor who has opted out altogether, since the Medicare limiting charge doesnt apply to doctors who have opted out of Medicare