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If you have symptoms like weakness or fatigue, heart palpitations, confusion, balance problems, infertility, pale skin, or loss of appetite, reach out to your healthcare provider to see if you should undergo a B12 screening, which involves a simple blood test

PMID: 25678787

But for vegans, supplements are a must to avoid deficiency. Malabsorption-Related Deficiency Protocols Malabsorption-related B12 deficiency needs a special treatment

CUGH (Consortium of Universities for Global Health)

MAT1 KO hepatocytes can also be detected with reduced methylation/CYP2E1 ratio, reduced mitochondrial membrane potential, increased ROS content, and are sensitive to ethanol and TNF--induced mitochondrial dysfunction