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References Sikiric P, et al

Continuous medical supervision ensures: Appropriate dose titration Monitoring for side effects Integration with lifestyle and nutrition plans Transition strategy if therapy is discontinued At The Clifford Clinic, therapy decisions are made collaboratively between doctor and patient after a detailed discussion of risks, benefits, and alternatives

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This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur