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Vitamin B 12 deficiency can express itself in the following clinical pictures: Hyperchrom macocytic megaloblast anemia (Perniciosa, Biermer-Anemia, Addison-Anemia

As ever, the process begins with accurate diagnosis

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M.EmperadorS.PinedaM.Lopez-GallardoE.MonteroR.YuberoD.et al

In severe cases, the body may struggle to absorb enough of the vitamin from oral sources leading to continued symptoms of deficiency

If you take methotrexate orally, it's worth noting that GLP-1 receptor agonists slow gastric emptying, which could potentially affect the absorption of oral medications