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Methotrexate (MTX) is a folate antagonist medication widely used as both a chemotherapy agent and a disease-modifying antirheumatic drug (DMARD) for autoimmune diseases such as rheumatoid arthritis and psoriasis

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Acneiform eruptions may be associated with higher individual vitamin B12 levels

The frequency of vitamin B12 injections varies depending on your unique health needs

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