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Addressing the Gaps in the Vitamin B12 Deficiency 2024 NICE Guidelines: Highlighting the Need for Better Recognition, Diagnosis, and Management of Pernicious Anaemia

Development of auto-antibodies Some cobalamin preparations in rare cases can stimulate an allergenic response where there is development of antibodies to the cobalmin injected

Many older adults do not eat sufficient animal products to meet B12 requirements, often due to dental issues and reduced appetite

Neelakantan H, Vance V, Wetzel MD, Wang HY, McHardy SF, Finnerty CC, Hommel JD, Watowich SJ. Selective and membrane-permeable small molecule inhibitors of nicotinamide N-methyltransferase reverse high-fat diet-induced obesity in mice. Biochem Pharmacol. 2018 Jul;154:161-171. doi: 10.1016/j.bcp.2018.05.003. Epub 2018 May 5. PMID: 29738706; PMCID: PMC6015571

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Pain management procedures are often closely monitored, making accuracy essential