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Many symptoms of B12 deficiency develop gradually, and patients who have experienced deficiency before often become attuned to their body's warning signs

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Testing Now, this leads me on to the tricky issue of testing for B12 because its not straight forward Im afraid

Note: No controlled KLOW trial has tested this schedule or established when skin changes should appear

Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team

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