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These might include: Persistent fatigue that seems disproportionate to liver disease severity Glossitis (sore, red tongue) or mouth ulcers Shortness of breath and palpitations due to anaemia Difficulty concentrating or 'brain fog' Mood disturbances including irritability or depression It is crucial to recognise that some symptomsparticularly fatigue and cognitive changesare common in both fatty liver disease and B12 deficiency, potentially leading to delayed diagnosis

Moderate to Severe Deficiency: For moderate to severe deficiencies, the dosage may increase to 1,000 mcg several times a week initially, followed by a maintenance dose

If the deficiency was purely dietary, oral supplementation may be considered after initial repletion