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A vitamin B12 injection is needed after gastric banding when oral supplementation has failed to correct a documented deficiency, serum B12 remains persistently low, the patient cannot adhere to daily oral tablets, or there are signs of neurological or haematological complications

Patients who have undergone gastric banding should be aware of the following signs that may indicate falling B12 levels and warrant prompt blood testing: Neurological symptoms: Tingling, numbness, or 'pins and needles' in the hands or feet Difficulty with balance or coordination Memory problems, difficulty concentrating, or 'brain fog' Mood changes, including low mood or irritability Haematological symptoms: Persistent fatigue or weakness disproportionate to activity levels Breathlessness on mild exertion Pallor or a slightly yellowish tinge to the skin Other indicators: A sore, smooth, or inflamed tongue (glossitis) Mouth ulcers occurring frequently It is important to recognise that some of these symptoms particularly fatigue and low mood are non-specific and may overlap with other post-operative nutritional deficiencies, such as iron or vitamin D deficiency

Muscle Stem Cell Rescue: It has been shown to rejuvenate senescent muscle stem cells (muSCs), restoring the regenerative capacity of aged skeletal muscle and significantly increasing grip strength and torque in animal models

found that supplementation with folic acid (the synthetic form) in girls with Down syndrome may not be as effective as the active form