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It is also important to note that taking large doses of folic acid can sometimes mask the hematological signs of a B12 deficiency, allowing neurological damage to progress unnoticed

HIF-1 activates glycolysis-related genes, including pyruvate dehydrogenase kinase 1 (PDK1), increasing the conversion of glucose to pyruvate and subsequently to lactate by inactivating PDH, which is considered critical for metabolic adaptation to hypoxia [74] [Figure 1F]

How low B12 is tested for Confirming a B12 problem starts with a serum B12 blood test

Immune-related adverse events and their management in peptide-based therapies. Therapeutic Advances in Chronic Disease , 7(4), 192208