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however, exceeding the recommended levels of vitamin B12 too much can also cause a decrease in shell thickness

Additional at-risk groups include: Vegans and strict vegetarians , who may have low dietary B12 intake People with autoimmune conditions , including pernicious anaemia or type 1 diabetes Individuals with gastrointestinal conditions such as Crohn's disease or coeliac disease, which impair nutrient absorption People who have undergone bariatric surgery , which can significantly reduce B12 absorption Long-term users of proton pump inhibitors (PPIs) or H2-receptor antagonists , which reduce gastric acid and impair B12 release from food Those with a family history of either pernicious anaemia or diabetes For these groups, simultaneous monitoring of B12 status and glycaemic markers is particularly important to avoid diagnostic errors

Balsalazide Is Superior to Mesalamine in the Time to Improvement of Signs and Symptoms of Acute Mild-to-Moderate Ulcerative Colitis

Constipation can build more slowly and persist as stomach and intestinal movement slows