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Common indications include: Pernicious anaemia – an autoimmune condition where the stomach cannot produce intrinsic factor, a protein necessary for B12 absorption [8] [9] Malabsorption disorders – including Crohn's disease, coeliac disease, or following gastric surgery Strict vegan or vegetarian diets with confirmed deficiency – though high-dose oral B12 may be sufficient if no malabsorption exists Certain medications – such as metformin or proton pump inhibitors that may interfere with B12 absorption [9] [10] Neurological symptoms – including peripheral neuropathy, memory problems, or balance difficulties related to deficiency Diagnosis should be confirmed through blood tests measuring serum B12 levels, full blood count, folate, and often anti-intrinsic factor antibodies