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Step 3: Draw bacteriostatic water Take a new insulin syringe

Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease

Follow-up Repeat metabolic markers after 8-12 weeks or sooner if appetite, hydration, vomiting, or glucose symptoms change

Interference with In Vivo Monitoring Devices The presence of methylene blue in the blood may result in an underestimation of the oxygen saturation reading by pulse oximetry