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B12 plays a role in the following human biological processes: Nerve and brain regeneration Adrenal gland support Male and female reproductive health Nutrient absorption Red blood cell formation Cellular energy Memory recall DNA synthesis Some of the risks associated with extended periods of depleted B12 levels are: Pernicious anemia Migraine headaches Macular degeneration Tinnitus Fatigue (adrenal fatigue and CFS) Multiple sclerosis Memory loss Neuropathy Anemia Asthma Shingles Kidney disease Depression Some possible causes for B12 deficiency are: You have leaky gut or digestive disease You are over 50 You have had Helicobacter pylori bacterial infection or stomach ulcer Are you a vegan or vegetarian You have acid reflux Youve had weight loss surgery You are taking one of the following medications: antibiotics, anti-gout, blood pressure, birth control pills, cholesterol-lowering drugs, diabetes medications, and antipsychotic drugs