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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

Deficiency can cause fatigue, weakness, and reduced physical capacity, all of which may limit an individual's ability to engage in regular physical activity or maintain healthy lifestyle behaviours

However, it may take about 2 weeks for it to settle (swelling to go down) and for you to see your final effects