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Pernicious anaemia is caused by a deficiency in vitamin B12, due to atrophic gastritis, an autoimmune condition (immune system destroys self), in this case the parietal cells of the stomach that produce intrinsic factor, a glycoprotein that binds to vitamin B12 in the stomach and is essential for normal absorption of vitamin B12 in the small intestine into the blood

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This duration allows sufficient time to produce meaningful fat loss results while avoiding the plateau effect that can occur with extended continuous use

These patients who do not fit the criteria but who remain undiagnosed B12 deficient patients become very expensive for the NHS to look after

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