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Peng Y, Felce SL, Dong D, Penkava F, Mentzer AJ, Yao X, et al

Arthur Heller, HealthTap There is also the risk of bacterial contamination, which increases as the B12 ages

NHS approach to B12 deficiency: NICE Clinical Knowledge Summaries recommend investigating B12 deficiency in patients presenting with macrocytic anaemia, unexplained neurological symptoms, or risk factors including pernicious anaemia, gastrectomy, malabsorption disorders, metformin use, proton pump inhibitors, or nitrous oxide exposure