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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

This can be due to weakening of the stomach lining (also known as atrophic gastritis), or to medications that reduce stomach acid

Headaches have been reported, though distinguishing these from coincidental occurrences proves difficult

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Our providers focus on finding the sweet spot for your dosageproviding enough to ensure you feel vibrant and healthy without over-supplementing beyond what your body can utilize