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Iron is absorbed in the Duodenum, most other nutrients in the Jejunum and our friend B12 in the Ileum

This condition is called anemia, or more specifically, pernicious anemia

In this unusual case, we present a patient with B12 deficiency who presents with severe macrocytic anemia, neutropenia, lymphocytosis, and a bone marrow morphology consistent with MDS

The comparative side effect profiles between the two medications show meaningful differences in specific GI symptoms

In addition to a complete history and examination, a full workup is often needed to diagnose the primary disease, which may include: Physical examination Diagnostic imaging Blood work Urinalysis Fecal testing Intestinal biopsy Once the underlying illness is diagnosed, identifying a B12 deficiency is fairly straightforward using a simple blood test

The conversation about whether the right context includes patients on GLP-1 therapy is the conversation worth having