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Individuals with risk factors for B12 deficiency including strict vegans, those with gastrointestinal conditions, patients taking long-term metformin or proton pump inhibitors, and older adultsshould discuss screening with their GP, even in the absence of obvious symptoms

Patients on chemotherapy should watch for signs of B12 deficiency

In practice a GP or nurse may administer off-licence by giving a sub-cutaneous (under the skin, SC) injection but it is important to remember that the GP makes their own decision and takes their own accountability and reliability if they go off-licence

Fragment 176-191 works through the blocking and killing of blood vessels which supply the fat cells or adipocytes