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Disruptions in the intrinsic factor (IF) pathway, including impaired IF production due to autoimmune conditions (pernicious anemia), damage to the ileum from diseases like Crohn’s or celiac disease, or surgical resection of the ileum, can severely impair B12 absorption
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They can: Assess your BMI (including ethnicity-adjusted thresholds where relevant), comorbidities, and overall cardiovascular risk Review contraindications and clinically important drug interactions — for example, orlistat can reduce absorption of ciclosporin, affect INR in those taking warfarin, and requires careful timing with levothyroxine