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This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur
Most people do not experience any side effects when taking vitamin B12 supplements or consuming foods that are rich in vitamin B12
Even with supplements, digestive problems or poor absorption can make it challenging to get enough B-12
Practical takeaway: If youre drinking on a ski trip, at a mountain event, or during air travel, treat your hydration needs as higher than usual, and dont assume your normal tolerance applies unchanged
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