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Since multiple species of Propionibacterium produce no exotoxins or endotoxins and have been granted GRAS status (generally regarded as safe) by the United States Food and Drug Administration, they are the preferred bacterial fermentation organisms for vitamin B 12 production

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thus, appropriate tests need to be carried out to rule out this condition if suspected.[16] Therapeutic response to cyanocobalamin may decrease due to elderly age, infection, renal insufficiency, diabetes mellitus, marrow suppressants use (e.g

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Common signs of a B12 deficiency include: Fatigue Weakness Pale skin Poor coordination Heart palpitations Loss of appetite Unexplained weight loss A B12 deficiency can also contribute to mental health issues like depression and cognitive issues like confusion and poor memory