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and patients with pernicious anemia who have optic neuropathy COBALAMIN (Vitamin B12) Deficiency Causes Vegetarians (dietary deficiency) Older adults: atrophic gastritis affects 10% 30% and leads to decrease in hydrochloric acid secretion in the stomach and decreased absorption of Vitamin B12 The liver can store up to six years worth of Vitamin B12 so deficiencies are rare Effects of deficiency Megaloblastic anaemia (pernicious anaemia) Progressive demyelination of nerve cells Elevation in levels of circulating homocysteine that leads to production of defective collagen and elastin with a negative impact on arteries, bone and skin Deep vein thrombosis is associated with homocysteinemia that causes the activation of the intrinsic coagulation cascade Symptoms include fatigue, weakness, constipation, loss of appetite and weight loss Numbness, tingling of the feet imbalance, depression, confusion, dementia, poor memory and glossitis

This approach has philosophical appeal for those seeking to optimize underlying biology rather than override it

This shift has paved the way for innovative strategies, including a small molecule peptide known as 5-amino-1mq

This method is great when taking pills doesnt work because the body cant absorb them well

For vegetarians, vegans, and people with digestive issues, getting enough B12 can be a challenge

Hydroxocobalamin is the form the NHS uses because it lingers in the body longer than cyanocobalamin