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
Delivery to Germany in 9 days
The rate of excretion is fast, there is no internal cupboard where we can pop a bit by for a rainy day
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If you are taking B12 supplements and suspect they may be contributing to anxiety, do not abruptly discontinue without medical advice, particularly if you have been diagnosed with deficiency
McWane Ductile has a great blog post on this procedure, which can be found here
