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Step 4: Let It Dissolve Do not shake the vial

If you think that's the case, I have to say that unless you're very lucky in having a GP who knows something about B12 deficiency, you may have to think about adding the extra yourself (sublinguals, patches, drops or self-injecting)

TOP Key Recommendations Routine B 12 screening and testing in asymptomatic patients is not supported by evidence

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As well as from poor diet and digestion, vitamin B12 deficiencies can also be affected by a genetic condition such as: o Pernicious anaemia o Crohns disease o Treatment with proton-pump inhibitors o Atrophic gastritis o Coeliac disease o Use of antacids (acid is required to release B12 from food) o Gastrointestinal surgery o Use of certain medications o Use of illegal drugs and substances including nitrous oxide