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Dietary and Lifestyle Risk Factors Certain diets and lifestyle factors also increase the risk of B12 deficiency

This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur

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Several factors influence how long MIC B12 remains active in the body: Individual metabolic rate Frequency of injection administration Overall health status Lifestyle factors Current nutritional status The body processes these water-soluble compounds efficiently, naturally eliminating any excess amounts through urination [11]