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Medical conditions affecting absorption warrant particular attention : Pernicious anaemia : an autoimmune condition destroying gastric parietal cells, requiring lifelong B12 injections Gastrointestinal surgery : particularly gastric bypass, gastrectomy, or terminal ileum resection Inflammatory bowel disease : Crohn's disease affecting the terminal ileum impairs absorption Coeliac disease : untreated disease damages the small intestine, reducing B12 uptake Medication use : long-term metformin therapy (MHRA safety alert) or nitrous oxide exposure Symptoms suggesting possible B12 deficiency include : persistent fatigue, weakness, paraesthesia (pins and needles) in hands or feet, glossitis (sore, red tongue), mood changes, memory problems, or unexplained anaemia
After drinking, alcohol spreads quickly through the bloodstream
The exact amount depends on the patients health, how bad the deficiency is, and how well they respond to treatment
Once reconstituted, refrigerate at 2-8 C and plan to use within 4-6 weeks (preferably less)
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