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The causes of B12 deficiency can be subdivided into congenital and acquired (Table 1)

Modifiable risk factors in knee osteoarthritis: treatment implications. Rheumatology international 39.7 (2019): 1145-1157

Call 999 or go to A&E immediately if you experience: Severe difficulty breathing or stridor (a high-pitched sound when breathing) Severe swelling in the throat or neck Drooling or inability to swallow liquids Severe chest pain Contact your GP or NHS 111 if you experience: Severe or worsening throat pain that interferes with swallowing or speaking Difficulty swallowing (dysphagia) , particularly if progressive or associated with pain Persistent symptoms not improving after a week High fever (38C or above) accompanying throat symptoms Visible swelling in the neck or throat Blood in saliva or phlegm Hoarseness lasting more than 3 weeks Severe symptoms of reflux , including persistent heartburn, regurgitation, or chest pain Unintentional weight loss beyond your treatment goals, or inability to maintain adequate nutrition Signs of dehydration , such as reduced urine output, dizziness, or extreme thirst Your GP will conduct a thorough assessment, which may include examination of your throat, neck, and lymph nodes

Gastroenterology practices may bill both the diagnostic code and endoscopy procedures when investigating the underlying cause

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Cold chain logistics should be used during transportation to ensure that the products remain stable in a low-temperature environment