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It's very common to get nutritional deficiencies in the perimenopause and menopause

J Neurosci Res (2018) 96(6):92750

Some pharmacokinetic studies suggest that only around 1.52.5 g of B12 is absorbed from food per meal, while approximately 5% of a 25 g dose and only 1% of a 1,000 g oral dose is effectively absorbed (Devi et al., 2020

And for the broader project of longevity medicine building a clinical practice that optimizes biology rather than reacting to disease the return of these compounds to legitimate access is a step in the right direction

In addition, on the peripheral blood smear, macrocytes and hypersegmented polymorphonuclear leukocytes may be seen