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2019;35(7):e3168

As well as from poor diet and digestion, vitamin B12 deficiencies can also be affected by a genetic condition such as: o Pernicious anaemia o Crohns disease o Treatment with proton-pump inhibitors o Atrophic gastritis o Coeliac disease o Use of antacids (acid is required to release B12 from food) o Gastrointestinal surgery o Use of certain medications o Use of illegal drugs and substances including nitrous oxide

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Safe use includes attending regular healthcare appointments, following dosing directions and staying nourished and hydrated to prevent nutrition gaps and side effects

The same interventions that worked pre-menopause often stop working