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Sharabi A, Cohen E, Sulkes J, Garty M (2003) Replacement therapy for vitamin B12 deficiency: comparison between the sublingual and oral route

A deficiency in Vitamin B12 can lead to fatigue and decreased energy, as your body struggles to deliver adequate oxygen to your cells

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Bypass surgery itself removes areas that produce necessary co-factors for absorption, which is compounded by faster gut transit time, which lessens what can be extracted from the digestive process

Meta-analysis The included studies showed substantial heterogeneity (I 2 = 99.6%, p 0.05), supporting the conclusion of comparable efficacy and the lack of a clear doseresponse relationship