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In the exposure cohort, index was defined as the date of the first systemic corticosteroid prescription or administration (whether oral or intramuscular injection) after an AD diagnosis

Proton pump inhibitors and similar medications that lower stomach acid might decrease the absorption of vitamin B12 from food, but this is less of a concern when receiving B12 injections because they bypass the digestive system entirely

However, if left untreated, it can progress and cause: Chronic fatigue and overall weakness Dizziness Pale or yellowish skin tone Mental health problems such as depression, mood swings, irritability, and anxiety Loss of appetite, nausea, and diarrhea, leading to weigh loss Paresthesia: numbness, tingling or burning sensation in feet, legs, and hands Vision problems Vitamin B12 is an essential nutrient, meaning everyone should get it either from food or supplements

Some self test options are available online