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So can the use of commonly prescribed heartburn drugs, which reduce acid production in the stomach (acid is needed to absorb vitamin B 12 )

(There are several studies involving animals, but not human subjects.) What research does show is that people who are overweight tend to be low in vitamin B12

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Rely on Symptoms To quote NEQAS: In the event of any discordance between clinical findings of B12 deficiency and a normal B12 laboratory result, then treatment should not be delayed

The patient may notice a lump of filler which can move (migrate) over time

Using a sterile luer-lock syringe, withdraw the required quantity