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Published evidence indicates that B12 deficiency can make HbA1c unreliable, but the direction of the distortion whether the result is spuriously high or spuriously low is variable and may depend on the degree of anaemia, the specific HbA1c assay used, and other concurrent conditions

Iron Deficiency Anemia: Periodic hematologic determination (hemoglobin and hematocrit) is a simple and accurate technique for monitoring hematological response, and should be used as a guide in therapy

Less common, whole-body effects

Vitamin B12 also helps prevent megaloblastic anaemia, a blood condition that makes people tired and weak