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sustained release from injection depot

Liposomal delivery improves absorption compared to standard oral forms

These include the following: IgG4-Related Variant, Juvenile Variant, Fibrous Variant, Hashitoxicosis Variant, and Painless (or silent) Thyroiditis

Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease

British Committee for Standards in Haematology (BCSH) guidance notes that a positive IF antibody test identifies patients needing lifelong cobalamin replacement