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If nausea and vomiting occur in early pregnancy and are not responsive to simple measures, such as reassurance and dietary changes, HG should be suspected (table 2)

If something reduces the function of any of the organs that break down the B12, then the amount utilised can be even less

Hyperpigmentation of skin has been reported only rarely as the presenting manifestation of vitamin B 12 deficiency.[2] There is only one such Indian report.[3] A 34-year-old Indian male presented with darkening of skin and discoloration of hair and nails for two months

This is significant for increasing B12 levels in individuals unable to absorb B12 from food or supplements due to their bodys condition