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In our practice, we occasionally see patients with unexplained fatigue, low mood, or difficulty concentrating, and sometimes these symptoms are related to low B12 levels

And we are also pleased to report that the BSH is now going to revisit their 2014 guideline with a view to updating it and we are excited to have been invited to be involved in the process and, of course, we will be happy to do so

210,216,217 A randomized placebo-controlled trial in 100 heart disease patients found 450 mg of pomegranate extract plus 180 mg vitamin E (as synthetic dl-alpha tocopherol) daily for eight weeks reduced expression of two vascular adhesion proteins and lowered levels of inflammatory markers

Consider these evidence-based dietary strategies: Eat small, frequent, low-fat meals that are easier to digest Limit sugar alcohols (sorbitol, mannitol, xylitol) found in sugar-free products, which have known laxative effects Gradually increase soluble fiber through foods like oatmeal and psyllium supplements, which can help bulk stools Avoid excessive insoluble fiber from raw vegetables and whole grains during acute episodes Stay adequately hydrated with water and electrolyte-containing beverages to prevent dehydration Avoid spicy, greasy, or very high-fiber foods during episodes of diarrhea Medication dosing may require adjustment

reconstituted vials must be maintained under constant refrigeration at 2C to 8C