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Vitamin B12 deficiency is relatively rare, but it is more common in people who follow a vegetarian or vegan diet, as it is found almost exclusively in animal-derived foods

About a month before coming in, my patient stubbed his toe

These might include: Persistent fatigue that seems disproportionate to liver disease severity Glossitis (sore, red tongue) or mouth ulcers Shortness of breath and palpitations due to anaemia Difficulty concentrating or 'brain fog' Mood disturbances including irritability or depression It is crucial to recognise that some symptomsparticularly fatigue and cognitive changesare common in both fatty liver disease and B12 deficiency, potentially leading to delayed diagnosis

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