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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

Treatment response depends on deficiency severity, route of administration, underlying cause, patient age, concurrent medical conditions, and medication interactions

O (Outcome): Primary outcome: changes in serum Vitamin B12 levels, clinical improvement of Vitamin B12 deficiency symptoms

In cases where absorption is an issue, Vitamin B12 injections may be necessary