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In fact, its thought that as many as 90% of the people who follow these diets are deficient in vitamin B-12 because one of the only natural sources for B-12 is in animal food products

Phytotherapy research : PTR

Severe deficiency can contribute to fatty liver changes, which is one reason choline gets framed as liver support. Details are summarized in the NIH ODS Choline fact sheet for health professionals

The frequency of B12 injections varies based on individual needs: For deficiency correction: Injections may be administered more frequently, such as weekly or monthly, until levels normalize. For maintenance: Once adequate levels are achieved, monthly injections are typically recommended

Protein is non-negotiable When appetite is significantly reduced, protein intake often drops first