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Deficiencies can occur with medical conditions such as atrophic gastritis (which causes thinning of the stomach lining), pernicious anaemia, Crohns disease, celiac disease, lupus, or other immune system disorders and certain medications

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As a retired nurse, all I can say about the nurse who said is.she has little knowledge of PA

Additional testing if symptomatic: Iron studies if fatigued, magnesium if experiencing cramps, and amylase/lipase if experiencing persistent abdominal pain (to rule out pancreatitis, a rare but serious side effect)

This means you receive care that is current, effective, and aligned with the most up-to-date research available

Without these supporting documents, payers may deny authorization under the rationale that oral B12 costs less and should be trialled first-a medically inappropriate request given the intrinsic factor pathophysiology