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H2 blockers provide somewhat weaker acid suppression than PPIs with potentially fewer long-term concerns

How Soon Will I Feel Results

Rapid-fermenting types like RS2 benefit proximal colonic conditions, while slower-fermenting RS1 may better support distal colonic health

The diagnostic process typically involves: Clinical history taking, focusing on symptoms (fatigue, neurological changes, dietary habits) Physical examination for signs of anaemia or neurological impairment Blood tests including full blood count, serum B12, and often folate levels Additional investigations such as intrinsic factor antibodies or parietal cell antibodies if pernicious anaemia is suspected For borderline results, additional tests like holotranscobalamin (active B12) may be considered NICE guidance recommends that treatment should commence based on clinical presentation if neurological symptoms are present, without waiting for laboratory confirmation, as delays can result in irreversible nerve damage

Stacking them targets two different rate-limiting steps at once

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