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If laboratory results indicate a deficiency, we can tailor a treatment plan that may include B12 injections as part of your personalized care

Medical conditions affecting absorption warrant particular attention : Pernicious anaemia : an autoimmune condition destroying gastric parietal cells, requiring lifelong B12 injections Gastrointestinal surgery : particularly gastric bypass, gastrectomy, or terminal ileum resection Inflammatory bowel disease : Crohn's disease affecting the terminal ileum impairs absorption Coeliac disease : untreated disease damages the small intestine, reducing B12 uptake Medication use : long-term metformin therapy (MHRA safety alert) or nitrous oxide exposure Symptoms suggesting possible B12 deficiency include : persistent fatigue, weakness, paraesthesia (pins and needles) in hands or feet, glossitis (sore, red tongue), mood changes, memory problems, or unexplained anaemia

H., Lin, A., Kitano, A., & Nakada, D

Ventura, R.J.A

However, hyperpigmentation often does not respond to topical treatments alone

Oral Hygiene: Clean your teeth as often as possible