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Medical conditions affecting absorption warrant particular attention : Pernicious anaemia : an autoimmune condition destroying gastric parietal cells, requiring lifelong B12 injections Gastrointestinal surgery : particularly gastric bypass, gastrectomy, or terminal ileum resection Inflammatory bowel disease : Crohn's disease affecting the terminal ileum impairs absorption Coeliac disease : untreated disease damages the small intestine, reducing B12 uptake Medication use : long-term metformin therapy (MHRA safety alert) or nitrous oxide exposure Symptoms suggesting possible B12 deficiency include : persistent fatigue, weakness, paraesthesia (pins and needles) in hands or feet, glossitis (sore, red tongue), mood changes, memory problems, or unexplained anaemia

Effectiveness of oral vs intravenous acetaminophen on pain management following total joint arthroplasty: A systematic review and meta-analysis

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[DOI] [PubMed] [Google Scholar] 26.Wegner HE, Andresen R, Knispel HH, Miller K

Sodium-glucose cotransporter-2 inhibitors and primary prevention of atherosclerotic cardiovascular disease: a meta-analysis of randomized trials and systematic review