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Your doctor may recommend reducing or stopping B12 supplementation, then retesting in 4 to 8 weeks

When to seek medical advice: Persistent or worsening injection site reactions (increasing redness, warmth, or discharge suggesting infection) Severe or persistent headaches Chest pain or palpitations Unexplained muscle weakness or cramps New or worsening neurological symptoms despite treatment Unexpected bleeding or bruising For non-emergency concerns, contact your GP or NHS 111

Acid in the stomach is essential for this function, so long-term use of strong acid-suppressing medications such as Aciphex (rabeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), Prilosec (omeprazole), or Protonix (pantoprazole) may contribute to a problem for some individuals, especially when taken for a long period of time

For people who take blood thinners In people who take blood thinners, such as clopidogrel and aspirin, a PPI or H2 blocker may be used to prevent stomach bleeding