Knowing the symptoms and recognizing at-risk populations is essential for maintaining optimal health
B12 injections are indicated for patients with documented deficiency, including those with pernicious anaemia, malabsorption disorders, following gastric surgery, or with neurological symptoms suggesting B12 deficiency
Long term prescription of medications such as the following are likely to increase the cause of, or exacerbate the risk of B12 deficiency - the proton pump inhibitors (esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole), famotidine, ranitidine, metformin, glibenclamide, gliclazide, glimepiride, glipizide, sodium valproate, gabapentin, doxycycline, some oral contraceptives
Kornerup LS, Hvas CL, Abild CB (2019) Early changes in vitamin B12 uptake and biomarker status following Roux-en-Y gastric bypass and sleeve gastrectomy
Furthermore, sprays allow for the vitamin to enter into the systemic circulation, bypassing the intestinal vessels
