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People taking certain common medications including metformin for blood sugar management and proton pump inhibitors for acid reflux also face increased deficiency risk

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the MHRA advises checking vitamin B12 levels if deficiency is suspected and considering periodic monitoring in those with risk factors [6] Chronic alcohol consumption can damage the gastric mucosa and impair absorption Nitrous oxide exposure (including recreational use) can inactivate vitamin B12 in the body, causing functional deficiency and neurological symptoms If you experience symptoms such as unexplained fatigue, pale skin, shortness of breath, neurological symptoms (tingling, numbness, balance problems), mood changes, or cognitive difficulties, contact your GP promptly