This immediately flags a common cause: Dietary Factors: Vegans and strict vegetarians are at a higher risk of deficiency if they dont consume fortified foods or supplements
When your appetite is very low: Lead with protein at every eating occasion and let the rest fill in around it
J Membrane Biol 256 , 223228 (2023)
Assumptions & Acronyms Used Research Methodology

Your doctor will conduct a comprehensive clinical assessment including: Detailed medication and supplement history , including over-the-counter vitamins and injections Review of symptoms suggesting liver, kidney, or haematological disease Physical examination for hepatomegaly, splenomegaly, jaundice, or lymphadenopathy Additional blood tests , such as full blood count, liver function tests, renal function, and inflammatory markers Depending on initial findings, further investigations may include: Liver ultrasound or imaging if hepatic pathology is suspected Haematology referral for blood film examination, bone marrow biopsy, or specific tests for myeloproliferative disorders Measurement of holotranscobalamin or methylmalonic acid if functional B12 status needs clarification despite high total B12 Targeted investigations based on clinical findings and following NICE guidance for suspected serious conditions Treatment focuses on addressing the underlying cause rather than the elevated B12 itself

Here is every real option mapped by tier and true monthly cost, including the cost-first runners-up and the brand path