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Cause of Low B12 levels Pernicious anaemia vegan diet malabsorption syndromes coeliac sprue Crohn's ulcerative colitis (UC) "food-bound cobalamin malabsorption syndrome" predisposing factors include atrophic gastritis, long term proton pump inhibitor or H2 antagnoist use, chronic alcoholism, gastrectomy/gastric bypass surgery, pancreatic exocrine failure, AIDS myeloma (paraprotein related assay interference) pregnancy combined oral contraceptive pill/HRT pancreatric insufficiency metformin, acute phase situations

Controlled preparation workflows

If you and your doctor decide to try vitamin B 12 pills, in whatever form, it will be important to have regular blood tests to be sure you're getting enough of the vitamin

Ensure patient comfort Phlebotomists often work with patients who may be nervous or uncomfortable with blood draws