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The four most common reasons are: pernicious anaemia (an autoimmune disorder of a lack of red blood cells due to the body not being to absorb enough vitamin B12) a vegetarian or vegan diet

Side effects are rare but may include mild pain or redness at the injection site

If the symptoms of vitamin B12 deficiency are not evident earlier because of the folate intake, the effects may become irreversible

Moderately low serum B12 concentrations between 148 or 150 and 221pmol/L or 260pmol/L are often considered indicative of depleted or subclinical B12 deficiency