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The 2024 NICE NG239 guideline on vitamin B12 deficiency in over-16s lists the main groups who need injections: Autoimmune gastritis (pernicious anaemia)

Meanwhile, they can be further divided into different categories based on their binding partner interactions, such as protein-ligand, polyaminoacid-matrix, antigen-antibody, and protein-protein interactions (Figure 1)

Patients are typically pre-medicated with folic acid, vitamin B12, and a corticosteroid (like dexamethasone) to help reduce the incidence and severity of some of these side effects, particularly skin reactions and bone marrow suppression

In addition to thyroid changes during pregnancy, we must be aware of thyroid health during the postpartum period