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One of the commonly reported microbiome differences between obese/HFD-fed animals and lean controls is an increased Firmicutes : Bacteroidetes ratio 43,44
If your goal is addressing a B12 deficiency, a B12 shot may be appropriate on its own
Chem Biol Interact
doi:10.1074/jbc.M111.310342 91
When the same provider performs both an evaluation and management service and administers an injection on the same date, the E/M must be appended with Modifier 25 to signal it was a significant, separately identifiable service
If you cant find saline-based shots, create your own B12 injection kit
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