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[51] Diagnosis [edit] According to one review: "At present, no 'gold standard' test exists for the diagnosis of vitamin B 12 deficiency and as a consequence the diagnosis requires consideration of both the clinical state of the patient and the results of investigations." [52] The vitamin deficiency is typically suspected when a routine complete blood count shows anemia with an elevated mean corpuscular volume (MCV)

Before the shot I had no energy whatsoever

You can get more vitamin B12 from chicken, eggs, and fish

The addition of high dose niacin was intended to increase HDL ("good") cholesterol, reduce elevated triglycerides, and, most importantly, reduce the risk of heart attacks and stoke