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Response: We understand commenters' concerns about measure ( specifications with regard to patient factors beyond the control of the facility

Well look at how B12 affects the nervous system and what happens when theres not enough

Improved Mood B12 plays a role in the production of neurotransmitters that regulate mood, such as serotonin and dopamine

189 In contrast, from a prophylactic approach, another research group proposed what they deemed a cost-effective approach of yearly injections of 1000 g of vitamin B12 to every patient on metformin to reduce the risk of deficiency and also stated that this could remove the requirement for annual screening, though this has not been empirically tested