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Mr Pritchard warned me that the B12 we are given does have preservatives and although I should/ could do with having it every six weeks it was making my migrain worse

CAUSE Shingles has been associated with ageing (the vast majority of cases are reported in people over 50 years of age), a weakened immune system, trauma, excessive sun exposure or chickenpox in children who are exposed either before birth or before 18 months of age

GLP-1 receptor agonists (semaglutide, liraglutide) are not contraindicated with levothyroxine but may affect gastric emptying and medication absorption

Certain groups face elevated risk of B12 deficiency and should discuss testing with their healthcare provider: Individuals following vegan or strict vegetarian diets without adequate supplementation Older adults (particularly those over 60 years), due to reduced gastric acid production People with gastrointestinal conditions including Crohn's disease, coeliac disease, or those who have undergone gastric or ileal surgery Long-term users of medications affecting B12 absorption, such as metformin (MHRA advises monitoring B12 levels), PPIs, or H2-receptor antagonists Individuals with pernicious anaemia or family history of this autoimmune condition People with exposure to nitrous oxide (recreational or occupational), which can cause functional B12 deficiency Diagnostic testing typically involves serum B12 measurement , though this may not always reflect tissue stores accurately

Patients exploring tesamorelin outside the HIV-lipodystrophy context should do so under specialist supervision with clear metabolic baselines documented