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Absorption Problems Some individuals consume enough B12 but cannot absorb it due to conditions such as: Pernicious anaemia: An autoimmune condition that affects stomach cells that produce intrinsic factors needed for B12 absorption Atrophic gastritis: Thinning of the stomach lining Lupus and B12 deficiency: Autoimmune diseases like lupus can reduce B12 absorption Surgical or Medical Interventions People who have undergone gastrointestinal surgeries (like weight loss surgery) or those taking certain medications (e.g., metformin or proton pump inhibitors) are at higher risk

We would urge anyone with any information or concerns, or indeed any practitioners who want additional support, to contact our environmental health team without delay. Any member of the public with any information or concerns, or any practitioners who want additional support, can contact City of Wolverhampton Councils environmental health team via [email protected]

This might happen if: Weight loss progress slows down Side effects are difficult to tolerate Blood sugar levels require better management Another medication may be better suited to the patients metabolism Instead of combining medications, providers typically transition patients carefully from one medication to another

Get the vial content and bac water volume right, keep units consistent, and cross-check the output against a rough manual calculation before drawing anything up