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Pernicious anaemia (an autoimmune condition affecting B12 absorption) is a common cause of B12 deficiency that requires specific testing for anti-intrinsic factor antibodies

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Summary: Diarrhoea is an uncommon side effect of vitamin B12 supplementation, occurring rarely and more often related to supplement formulation or excipients than the vitamin itself

This is most relevant when vitamin B12 deficiency is being corrected and broader B-vitamin support is clinically appropriate, where symptoms include a combination of fatigue, neurological features, and stress, or where rapid repletion and functional support are desired