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Contact your GP for B12 testing if you have: Symptoms suggesting deficiency (persistent fatigue, pins and needles, memory problems, glossitis) Risk factors for deficiency (vegan diet, gastric surgery, long-term metformin or proton pump inhibitor use) [1] [4] Concerns about whether your current supplementation dose is appropriate Underlying conditions affecting B12 metabolism (kidney disease, liver disease) Unexplained high B12 levels on a blood test when not taking supplements Routine monitoring is essential for patients receiving therapeutic B12 injections

Practical steps that may help include: Nutritional assessment : A GP can arrange blood tests to check for deficiencies in ferritin, iron, vitamin B12, folate, vitamin D, and thyroid function all of which can contribute to hair loss independently of tamoxifen

CO-197 Precertification or Authorization Absent Most common cause: IV iron infusions or ESA therapy administered without prior authorization

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