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Nature 606 , 732738 (2022)

Medical conditions affecting absorption warrant particular attention : Pernicious anaemia : an autoimmune condition destroying gastric parietal cells, requiring lifelong B12 injections Gastrointestinal surgery : particularly gastric bypass, gastrectomy, or terminal ileum resection Inflammatory bowel disease : Crohn's disease affecting the terminal ileum impairs absorption Coeliac disease : untreated disease damages the small intestine, reducing B12 uptake Medication use : long-term metformin therapy (MHRA safety alert) or nitrous oxide exposure Symptoms suggesting possible B12 deficiency include : persistent fatigue, weakness, paraesthesia (pins and needles) in hands or feet, glossitis (sore, red tongue), mood changes, memory problems, or unexplained anaemia

May Support: Cellular Energy Production* Bluebonnets Acetyl L-Carnitine 500 mg Vegetable Capsules are formulated with the free-form amino acid acetyl L-carnitine to help support cellular energy production.*Vegan, Gluten-Free, Kosher Certified, Soy-Free

Eur J Pain 12:351-60, 2008