The use of methotrexate may additionally invalidate diagnostic assays for folic acid and vitamin B12
You should seek medical advice if you experience: Persistent constipation that is not improving after trying self-care measures for a few weeks Blood in your stools (either bright red or dark, tar-like stools) Unexplained weight loss accompanying bowel changes Severe abdominal pain or bloating that is worsening or persistent Alternating constipation and diarrhoea that is persistent or recurrent A significant change in your normal bowel pattern, particularly if you are aged 60 or over with change to looser or more frequent stools, or aged 50 or over with unexplained rectal bleeding Symptoms of bowel obstruction such as inability to pass wind, severe cramping, or vomiting According to NICE guidance , these features may indicate conditions requiring investigation, including colorectal cancer, inflammatory bowel disease, or other gastrointestinal disorders
These include: Complete Blood Count (CBC) to check for better anemia Serum Vitamin B12 levels to make sure the dose is right Methylmalonic acid (MMA) and homocysteine levels to see how the body is reacting Reticulocyte count to see how the bone marrow is doing Clinical Improvement Markers We also watch for signs of improvement in how patients feel
It is also available as a supplement in both oral and injectable forms
Across all six studies, the safety findings were consistent: no serious adverse events, no immunogenic responses, no changes in IGF-1, no glucose or insulin disruption
Vitamin B12 injections can be a useful supplementation method for vegans and vegetarians who might struggle to maintain healthy vitamin B12 levels through diet alone
