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the MHRA advises checking vitamin B12 levels if deficiency is suspected and considering periodic monitoring in those with risk factors [6] Chronic alcohol consumption can damage the gastric mucosa and impair absorption Nitrous oxide exposure (including recreational use) can inactivate vitamin B12 in the body, causing functional deficiency and neurological symptoms If you experience symptoms such as unexplained fatigue, pale skin, shortness of breath, neurological symptoms (tingling, numbness, balance problems), mood changes, or cognitive difficulties, contact your GP promptly

If you start to feel symptoms returning before your next scheduled shot, its a sign to discuss this with your GP, as your programme might need adjusting

But, your hair follicles, located just under the surface of your skin, are very much alive

Malabsorption from coeliac disease, Crohns, gastric surgery or long-term metformin and proton-pump inhibitors accounts for much of the rest

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They are described in the new NHG (Dutch College of General practitioners) guidelines