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Certain foods and drinks can also affect how well the antibiotic works

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This includes people with: Pernicious anaemia (autoimmune destruction of intrinsic factor-producing cells), typically requiring lifelong IM injections Crohn's disease or surgical resection affecting the terminal ileum Coeliac disease causing malabsorption (may improve with gluten-free diet) Chronic pancreatitis reducing enzyme availability needed for B12 release Vegans and strict vegetarians need reliable B12 sources through fortified foods or supplements, as plant-based diets contain negligible amounts of active B12

Lauren Manaker is an award-winning registered dietitian-nutritionist and MegaFood Brand Ambassador, with a Master of Science in Clinical Nutrition

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