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For observational studies reporting serum vitamin B12 levels, the certainty of evidence was upgraded from low to moderate due to the large and consistent magnitude of effect across studies, despite heterogeneity

Some patients experience itching or a nodule at the injection site

Any legitimate supply flows through a treating specialist and hospital protocol

Recognising these factors is essential for identifying at-risk individuals and implementing appropriate supplementation strategies

That means eating foods that are rich in animal proteins, which are the main source for B12: Vegans and vegetarians who dont eat animal products may include a B12 supplement in their diet