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Many patients have successfully learnt to self-administer B 12 by intramuscular injection, which reduces both healthcare costs and burden on GP practices, and allows people who are B 12 deficient to optimise their treatment regimen.6566 Case example A man in his 70s presents with a nine month history of difficulty walking and climbing stairs, numbness and pain in his lower limbs, and paraesthesia in his hands

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The older baboons displayed a significant decrease in ZO-1, occludin, and JAM-A proteins, and an increase in claudin-2 expression, all of which correlated with increased permeability in the old aged group [66]