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A 2025 European Journal of Clinical Nutrition commentary on the NICE guideline argued that the diagnostic threshold and clinical awareness still need to be tightened further, especially around pernicious anaemia, which is still under-recognised in primary care

That regulatory status is important for patients to understand, but it should be separated from the biological research

What's the evidence

Vitamin B12 exists in several forms and contains the mineral cobalt [1-4], so compounds with vitamin B12 activity are collectively called cobalamins