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Mucosal Atomization Device tips were donated by Teleflex (Morrisville, NC, USA)

Bacteriostatic Water Sterile water for injection with 0.9% benzyl alcohol as a preservative

There are many ways in which our cognitive ability can be reduced or damaged, whether through aging, genetics, traumatic injury, or any number of other factors

Several factors can impair B12 absorption: Reduced stomach acid production (achlorhydria or hypochlorhydria), common in older adults and those taking proton pump inhibitors or H2-receptor antagonists long-term, impairs the release of B12 from food proteins Pernicious anaemia , an autoimmune condition destroying parietal cells and reducing intrinsic factor production, completely blocks the primary absorption pathway Gastrointestinal disorders including Crohn's disease, coeliac disease, or surgical removal of stomach or ileum sections directly damage absorption sites Metformin , commonly prescribed for type 2 diabetes, may reduce B12 absorption through unclear mechanisms