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This includes people with: Pernicious anaemia (autoimmune destruction of intrinsic factor-producing cells), typically requiring lifelong IM injections Crohn's disease or surgical resection affecting the terminal ileum Coeliac disease causing malabsorption (may improve with gluten-free diet) Chronic pancreatitis reducing enzyme availability needed for B12 release Vegans and strict vegetarians need reliable B12 sources through fortified foods or supplements, as plant-based diets contain negligible amounts of active B12

As well as the pain and discomfort of the growths, patients struggle with the social impact of the disease, with HS patients experiencing an estimated 50% higher risk of depression and double the risk of suicide 2,3

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Please see Christines words below Subject: Debate on B12 becoming an OTC medicine on 26 May 2021 Dear Nadine Dorries, You wanted to hear the stories of B12 deficiency sufferers here goes: I have had B12 deficiency for 9 years now