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For psoriasis, topical peptides can deliver high concentrations directly to inflamed plaques without significant systemic exposure

Contact your GP for B12 testing if you have: Symptoms suggesting deficiency (persistent fatigue, pins and needles, memory problems, glossitis) Risk factors for deficiency (vegan diet, gastric surgery, long-term metformin or proton pump inhibitor use) [1] [4] Concerns about whether your current supplementation dose is appropriate Underlying conditions affecting B12 metabolism (kidney disease, liver disease) Unexplained high B12 levels on a blood test when not taking supplements Routine monitoring is essential for patients receiving therapeutic B12 injections

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Transient potassium replacement at the initial stage of vitamin B 12 replacement, especially in those with low-normal serum potassium, can prevent subsequent hypokalaemia

Grace Whitmer Senior Clinical Dietitian

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