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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

2.4.1 Other potential methods for overcoming anti CD38 mAbs resistance: the role of CD47 CD47, an integrin-associated receptor, is widely expressed on the surface of many cell types, including red blood cells and cancer cells (60)

Often used inappropriately, some research studies suggest that Nexium and other PPIs are suitable for short-term use only

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