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Decreased stomach acid Atrophic gastritis Autoimmune pernicious anaemia Helicobacter pylori Gastrectomy, partial or complete Gastric bypass surgery (weight loss) Intestinal resection Partial or complete ileectomy Gastrointestinal neoplasms Malnutrition Eating disorders anorexia bulimia Inadequate diet Vegetarianism / veganism Malabsorption syndromes Alcoholism Crohns disease Coeliac disease (gluten enteropathy) Dipphyllobothrium infection blind loop syndrome diverticulosis inflammatory bowel disease small bowel overgrowth tropical sprue gastric irradiation ileal irradiation (bladder,cervix, uterus,prostate) Inborn errors of B12 metabolism Transcobalamin II deficiency Pancreatic exocrine insufficiency & Chronic pancreatitis Imerslund Gresbeck syndrome Zollinger Ellison Syndrome Bacterial overgrowth (small bowel) Fish tapeworm Advanced liver disease Drug induced causes Please note

You must be psychologically ready and have a solid yearning to reach your weight loss goals

It supports red blood cell production, helps maintain a healthy nervous system, and is crucial for energy metabolism

The needle length will vary accordingly

Keep a journal of any changes you notice