Before starting therapy , healthcare providers should conduct a comprehensive assessment including: Cardiovascular history : Document any history of heart disease, arrhythmias, heart failure, or stroke Baseline vital signs : Measure heart rate, blood pressure, and weight Medication review : Identify potential interactions, particularly with antihypertensives, diuretics, and anticoagulants Laboratory tests : Check renal function, liver enzymes, lipid profile, and HbA1c (if diabetic) ECG : Consider baseline electrocardiogram for patients with known cardiac disease or significant risk factors, though this is not routinely required for all patients During treatment , regular follow-up is essential
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Vitamin B12 injections for pernicious anaemia are the gold-standard treatment in the UK, delivering hydroxocobalamin intramuscularly to bypass the absorption problem
