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If the cause isn't dietary then it is an absorption problem so you need to find another way of replenishing B12 initially

What they can do is improve the breakdown of the food you ate so the digestive workload feels lighter

The triacylglycerol synthesis enzyme DGAT1 also catalyzes the synthesis of diacylglycerols, waxes, and retinyl esters

A large number of studies have investigated peripheral metabolomic changes in the aforementioned conditions, with considerable overlap between PAIS, CFS, and immunometabolic depression: As reviewed by Komaroff et al., the systemic metabolomic changes in ME/CFS patients are characterized by (1) an impairment in the production of ATP from all energy substrates, (2) a general hypometabolic state and (3) an imbalance between pro- and antioxidant metabolites favouring pro-oxidant processes [43, 62]

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