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Medicine has a very hard time telling a patient "we have no idea", never mind how frequently that is in fact the case

The ability to absorb vitamin B12 from food often decreases with age

A 2025 European Journal of Clinical Nutrition commentary on the NICE guideline argued that the diagnostic threshold and clinical awareness still need to be tightened further, especially around pernicious anaemia, which is still under-recognised in primary care

If you often feel tired despite sufficient rest, it might be worth considering your B12 levels