Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease
Received: Revised: Accepted: Published: Version of record: Issue date: DOI:
Some people experience feeling worse after receiving a vitamin B12 injection, which can be disconcerting when you expected improvement
Methylcobalamin is also active within the human body and found mainly in blood plasma, cytosol cells and certain body fluids like cerebral spinal fluid
Z71.3 Dietary counseling and surveillance This code is used to report encounters where dietary advice and monitoring are provided to patients aiming for weight loss or managing nutritional issues