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According to NICE guidance and standard UK clinical practice, patients with confirmed B12 deficiency and neurological symptoms typically require initial treatment with hydroxocobalamin injections

J Clin Endocrinol Metab 2006;91:799-805

Sometimes yes, sometimes no

Moreover, it was pointed out that gliflozin-induced infection, cancers, liver injury, hypoglycemia, and hypovolemia dehydration, hypovolemia, but mostly hypotension or orthostatic hypotension, and hemoconcentration (and thereby, the risk for thrombosis) affected bone metabolism and increased the risk of fracture [42,43,44]

Vitamin B12 deficiencies have many signs and symptoms