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GPs can prescribe B12 injections following appropriate investigation, which should include: Full blood count to identify macrocytic anaemia Serum B12 and folate levels to confirm deficiency (using laboratory-specific reference ranges) Methylmalonic acid and/or homocysteine when B12 results are borderline Intrinsic factor antibodies if pernicious anaemia is suspected Additional tests depending on clinical presentation (e.g., thyroid function, coeliac serology) When both B12 and folate deficiency are present, B12 should be replaced before folate to avoid precipitating subacute combined degeneration of the spinal cord

This eliminates the temperature swings from frequent opening and closing associated with a kitchen refrigerator

TB-500 suppresses pro-inflammatory cytokines (TNF-, IL-1) while increasing anti-inflammatory mediators like IL-10, leading to decreased immune-mediated tissue damage

The choice depends on the patients specific needs and the doctors evaluation