A total of 12 events were reported in five participants (35.7%) in the normal hepatic function group, three events in three participants (42.9%) in the mild hepatic impairment group and one event in one participant (14.3%) in the moderate hepatic impairment group
Testing costs remain modest and provide valuable guidance for adjusting supplementation
BRIGHTEN YOUR SKIN
For patients seeking weight loss who request B12 injections, GPs should: Assess for genuine deficiency through appropriate blood tests rather than empirical treatment Provide education about the lack of evidence supporting B12 for weight loss in non-deficient individuals Explore underlying concerns about weight and energy levels, addressing these through appropriate channels Signpost to evidence-based resources such as NHS weight management services according to local pathways Patients should contact their GP if they experience unexplained fatigue, neurological symptoms (numbness, tingling, balance problems), or signs of anaemia (pallor, breathlessness, palpitations), as these may indicate B12 deficiency requiring investigation
For example, when aliquoting into multiple tubes, its not a bad idea to keep the vial on a chilled rack (or ice pack) to minimize time at room temp
This suggests that multiple distinct immune cell types appear to participate in the chronic inflammatory response and subsequent behavioral changes found in patients with depression
