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The following things can cause anaemia Pernicious anaemia Conditions that affect the stomach Surgery to remove all or part of the stomach (gastrectomy) Conditions that affect the intestines e.g crohns disease, Chronic gastritis (an autoimmune condition where the body attacks its own tissues) Lack of vitamins in your diet (Strict vegetarianism) Medicines (a doctor would monitor this with regular blood test to inform patient of B12 levels) Prophylaxis of macrocytic anaemia associated with vitamin B12 The below is recommended for diet related B12 deficiency

The Yellow Card scheme: guidance for healthcare professionals, patients and the public

[DOI] [PubMed] [Google Scholar] 52.Howard BV, Klimes I, Vasquez B, Brady D, Nagulesparan M, Unger RH

If you have concerns about your B12 levels, talk with a registered dietitian or your healthcare provider, said Heather Greenlee, ND, PhD, MPH, an American Society of Clinical Oncology (ASCO) expert and medical director of the Integrative Medicine Program at Fred Hutch

NYU Langone Medical Center

Metabolic factors influencing menstrual function during weight loss: Leptin levels: This adipocyte-derived hormone decreases with fat loss and plays a crucial role in reproductive function signaling Insulin sensitivity: Improved insulin sensitivity can normalize androgen levels, particularly beneficial in PCOS Inflammatory markers: Reduction in chronic low-grade inflammation associated with obesity Sex hormone-binding globulin (SHBG): Levels typically increase with weight loss, affecting free hormone availability For women with obesity-related reproductive dysfunction, particularly those with PCOS, moderate and sustained weight loss often improves menstrual regularity over time