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This includes confirmed low serum vitamin B12 levels, pernicious anaemia, malabsorption states such as coeliac disease, inflammatory bowel disease, or post-gastric or bariatric surgery, unexplained anaemia, neuropathy or neurological symptoms consistent with vitamin B12 deficiency, a long-term vegan diet with symptoms or low levels, or failure of oral vitamin B12 supplementation
Maggi and Scotti, 2019
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Ungar, PhD, a professor at Penn Engineering, notes that while clinical trials are excellent at flagging high-risk safety concerns, they often overlook the day-to-day symptoms that bother patients the most
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