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The diagnostic process typically involves: Clinical history taking, focusing on symptoms (fatigue, neurological changes, dietary habits) Physical examination for signs of anaemia or neurological impairment Blood tests including full blood count, serum B12, and often folate levels Additional investigations such as intrinsic factor antibodies or parietal cell antibodies if pernicious anaemia is suspected For borderline results, additional tests like holotranscobalamin (active B12) may be considered NICE guidance recommends that treatment should commence based on clinical presentation if neurological symptoms are present, without waiting for laboratory confirmation, as delays can result in irreversible nerve damage

Other reported effects include headaches, dizziness, nausea, and gastrointestinal discomfort, though these are less common

doi: 10.1016/j.mehy.2020.110374, 6

Some facilities may offer membership options, including regular consultations and monitoring services

It's not that they are not trying hard enough, or trying in the right direction