And its just not true, said Dr
People with symptoms of vitamin B12 deficiency It is a good idea for anyone with the following signs and symptoms of a vitamin B12 deficiency or pernicious anemia to consult a doctor: People with gastrointestinal issues Conditions that affect the gastrointestinal tract may affect vitamin B12 release or absorption, including: pernicious anemia, which can lead to gastric atrophy, or damage to the stomach fish tapeworm infestation bowel or pancreatic cancer folic acid deficiency overgrowth of bacteria in the small intestine diabetes thyroid disease Crohns disease celiac disease chronic pancreatitis People who have undergone gastrointestinal surgery, including weight loss, may have fewer cells necessary to secrete stomach acid and intrinsic factor

Blood tests for TMAO are currently being developed and validated (such as at the Cleveland Heartlab), so patients with an elevated risk of cardiovascular disease may ask their doctor about the availability of such a test to determine how strongly indicated a dietary modification would be
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