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consider periodic monitoring in at-risk patients) Those taking PPIs or H2-antagonists for extended periods Post-bariatric surgery patients (routine supplementation according to BOMSS guidelines) Elderly individuals with atrophic gastritis Patients with inflammatory bowel disease affecting the terminal ileum Patient safety advice includes recognising warning signs of deficiency recurrence: increasing fatigue, neurological symptoms (numbness, tingling, balance problems), or mood changes

The immune system then mounts a defense, only this defense goes overboard and causes a bigger reaction than what is considered normal