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Technology is also paving the way for easier access and personal tracking

It includes 1-5 intramuscular or subcutaneous injections of 1000 mcg crystalline cyanocobalamin daily, followed by oral doses of 1000-2000 mcg/day Parenteral administration should be reserved for those with significant neurological symptoms NICE guideline: Vitamin B 12 deficiency in over 16s: diagnosis and management: Malabsorption as the confirmed or suspected cause of vitamin B 12 deficiency: Offer replacement to people if: lifelong intramuscular vitamin B12 Autoimmune gastritis is the cause They have had a total gastrectomy They have had a complete terminal ileal resection If the person has a vitamin B 12 deficiency because of malabsorption that is not caused by autoimmune gastritis, or a total gastrectomy or complete terminal ileal resection (for example, malabsorption caused by coeliac disease, partial gastrectomy or some forms of bariatric surgery): Offer vitamin B 12 replacement and Consider intramuscular instead of

(1) Brcic L, Brcic I, Staresinic M, Novinscak T, Sikiric P, Seiwerth S

The formula addresses this from four angles simultaneously: providing BPC-157 to support the GI environment, feeding butyrate-producing microbes with MicrobiomeX prebiotic, supplying a butyrate-producing bacterial strain directly (Clostridium butyricum), and delivering preformed butyrate to the colon via ButyroGen tributyrin

In fact, there are no NICE guidelines relating to Pernicious Anaemia, just a Clinical Knowledge Summary which has a glaring error in it (weve pointed this out to NICE who are considering revising it)

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