Symptoms can be subtle, but B12 shots can completely change how you feel on a day to day basis
A 2021 systematic review of 16 randomized controlled trials and 6,276 participants (Markun and colleagues, Effects of Vitamin B12 Supplementation on Cognitive Function, Depressive Symptoms, and Fatigue, Nutrients, 2021) found that B12 supplementation does not reliably reduce fatigue in people who are not deficient
One study shows that women who had lower than 250 mg/Dl levels of vitamin B12 were 3x more likely to give birth to a child with a birth defect than those who didnt
Shakeri A, Wang Y, Zhao Y, Landau S, Perera K, Lee J, Radisic M (2023) Engineering organ-on-a-chip systems for vascular diseases