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If you have an absorption issue (which is anyone that has low B12 and is symptomatic of a deficiency but consumes a normal diet including animal derived products) you NEED the injections

Proc Natl Acad Sci USA 1995

Referral to hepatology is recommended for patients with: Elevated fibrosis risk on FIB-4 or ELF testing (per NICE NG49) Signs of decompensation : jaundice, ascites (abdominal swelling), hepatic encephalopathy (confusion), or gastrointestinal bleeding Uncertain diagnosis or complex management needs Nutritional support from a dietitian experienced in liver disease can optimise outcomes

This landmark study provides proof of principle for the concept that the mechanical stress on the airways imposed by bronchoconstriction might contribute to airway remodelling