This gives you plenty of room to titrate up if your doctor sees fit
So it can be tough for a doctor to determine that vitamin B12 deficiency is the problem, unless youve taken a baseline test beforehand and already know that your B12 levels are lower than they should be
B12 testing is recommended in patients with fatty liver disease who have: Symptoms suggestive of deficiency (anaemia, neuropathy, cognitive changes) Long-term metformin use (MHRA 2022 guidance advises monitoring) Long-term proton pump inhibitor use Vegetarian or vegan diets Conditions affecting absorption (pernicious anaemia, coeliac disease, gastric surgery) Advanced liver disease (NASH, fibrosis, or cirrhosis) Monitoring frequency should be individualised based on disease severity and risk factors
doi:10.1016/j.bcp.2018.05.003 Neelakantan H, Brightwell CR, Graber TG, et al
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