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Appropriate trained and qualified staff may need to be deployed to these locations when time permits, and the capacity of general healthcare staff capacity to provide mental health and psychosocial support should be increased (see the mhGAP Humanitarian Intervention Guide)

The product should be formulated to minimize exposure to destabilizing agents, such as strong acids or excessive heat

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Common causes include: Pernicious anaemia Malabsorption disorders (e.g., coeliac disease, Crohns) Chronic alcohol abuse Long-term use of antacids or metformin Vegan or vegetarian diet without supplementation 3

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