but some of the worse skin I have seen is when I have seen people take advice from something they have seen on IG, and just gone and spent a load of money on expensive products willy-nilly, without any advice - or they use too much and it makes their skin worse
By doing this, we can get the best results for our patients

Your doctor will conduct a comprehensive clinical assessment including: Detailed medication and supplement history , including over-the-counter vitamins and injections Review of symptoms suggesting liver, kidney, or haematological disease Physical examination for hepatomegaly, splenomegaly, jaundice, or lymphadenopathy Additional blood tests , such as full blood count, liver function tests, renal function, and inflammatory markers Depending on initial findings, further investigations may include: Liver ultrasound or imaging if hepatic pathology is suspected Haematology referral for blood film examination, bone marrow biopsy, or specific tests for myeloproliferative disorders Measurement of holotranscobalamin or methylmalonic acid if functional B12 status needs clarification despite high total B12 Targeted investigations based on clinical findings and following NICE guidance for suspected serious conditions Treatment focuses on addressing the underlying cause rather than the elevated B12 itself

He came up with the idea after treating young boys with Frhlich syndrome, a rare hormonal disorder that causes obesity
Long-term metformin use clearly associates with increased b12 deficiency rates