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What you might notice with regular use

Dysregulation of this axis underpins comorbidities such as heart failure-associated cognitive decline and Takotsubo cardiomyopathy, where emotional stress triggers acute cardiac dysfunction [80]

Acquired causes of B12 deficiency can be 1) dietary, especially in vegetarian and vegan populations, 2) autoimmune, as seen in pernicious anaemia, where there is destruction of IF-producing parietal cells mediated by autoantibodies, 3) iatrogenic secondary to disruption of the acid-base status of the stomach (e.g., with proton pump inhibitor use or metformin), and 4) caused by malfunction of the terminal ileum (e.g., inflammatory bowel diseases like Crohns disease, gastric bypass or surgical resection)

Require diagnosis and monitoring: Some conditions (like high blood pressure, diabetes, or bacterial infections) need a professional diagnosis and ongoing monitoring

Given that I have no viral infection, this was an immune response to one of the COVID virus-related component of the vaccine