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The concern is amplified in specific patient groups who are already at elevated risk of B12 deficiency, including: Older adults , in whom gastric acid secretion naturally declines with age Individuals following vegetarian or vegan diets , who may have limited dietary B12 intake Those taking metformin , a commonly co-prescribed medicine for type 2 diabetes that is independently associated with reduced B12 absorption the MHRA Drug Safety Update (2022) advises monitoring B12 in symptomatic or at-risk patients taking metformin [13] Patients taking long-term proton pump inhibitors (PPIs) or H2-receptor antagonists , which reduce gastric acid and may impair B12 release from food Patients with a history of gastrointestinal surgery , including bariatric procedures Those with pernicious anaemia or other autoimmune conditions affecting intrinsic factor production Patients with coeliac disease, inflammatory bowel disease, or significant alcohol use , which may impair absorption Vitamin B12 plays an essential role in red blood cell formation, neurological function, and DNA synthesis

Typical applications include cell culture experiments assessing telomere dynamics and replicative potential, as well as animal studies monitoring physiological markers and longevity indicators

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