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According to the International Journal of Current Science , the procedure begins with collecting 10-20 milliliters of blood from the patient using standard venipuncture techniques

doi: 10.1016/j.jdermsci.2014.11.007

While the official number of people who are deficient in B12 is not very high, sub-clinical deficiencies or generally low B12 levels can still produce symptoms

One possible mechanism is the induction of local oxidative stress, generating Reactive Oxygen Species (ROS) because of the thiol group, which rapidly undergoes autoxidation in the presence of oxygen and metal ion

(PubMed) Clarke R, Smith AD, Jobst KA, Refsum H, Sutton L, Ueland PM

These wider effects introduce multiple biological variables during fat specific studies