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A peripheral blood smear would show hypersegmented neutrophils, with a portion of the neutrophils having greater than or equal to five lobes

Support should involve reducing any gastritis and H pylori levels and bypassing the enteric route for B12 absorption by using sublingual B12 or injections

Endurance athletes face unique challenges that may increase B12 needs: prolonged training sessions stress the digestive system, potentially impairing absorption, while increased red blood cell turnover demands consistent B12 availability

Tracking progress systematically identifies when dose modifications might help and when other factors need attention

Other Ways to Supplement With Vitamin B12 If blood tests indicate that youre dealing with a vitamin B12 deficiency and you arent a fan of needles, you have a few ways to up your intake

In the United States, most nutraceuticals are regulated as dietary supplements and food additives by the FDA