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Individuals with risk factors for B12 deficiency including strict vegans, those with gastrointestinal conditions, patients taking long-term metformin or proton pump inhibitors, and older adultsshould discuss screening with their GP, even in the absence of obvious symptoms

Neither NICE nor the MHRA has issued guidance recommending retatrutide, as it remains unlicensed

PLoS One 2015;10:e0129915 10.1371/journal.pone.0129915 [DOI] [PMC free article] [PubMed] [Google Scholar] 17

Its deficiency is seen in people with poor nutrition, infection, cancer, surgery, alcohol, pernicious anemia, medications (PPIs or other acid-suppressing drugs), exposure to nitrous oxide (during surgery or recreational use), stomach/intestinal problems such as intestinal dysbiosis, leaky gut or gut inflammation, atrophic gastritis or hypochlorhydria (low stomach acid) and/or nerve damage