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Francesco Puppi, recent podium finisher of the Western States 100, wrote a thoughtful piece about the state of drug testing in ultras following the high profile test failure of Joyline Chepngeno in 2025

If you know your levels are low, B12 supplements are a great start, but you're going to be playing catch-up, so dont expect things to be back to normal immediately

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Coverage is more likely if you have an underlying health condition that prevents your body from properly absorbing Vitamin B12 from food or supplements, such as pernicious anemia or certain gastrointestinal disorders, or if you have had specific surgeries like gastric bypass