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2.5 Quality assessment and risk of bias In line with PRISMA guidelines, the assessment of methodological quality was conducted to evaluate the strength of evidence, recognising that methodological limitations may introduce bias

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The following things can cause anaemia Pernicious anaemia Conditions that affect the stomach Surgery to remove all or part of the stomach (gastrectomy) Conditions that affect the intestines e.g crohns disease, Chronic gastritis (an autoimmune condition where the body attacks its own tissues) Lack of vitamins in your diet (Strict vegetarianism) Medicines (a doctor would monitor this with regular blood test to inform patient of B12 levels) Prophylaxis of macrocytic anaemia associated with vitamin B12 The below is recommended for diet related B12 deficiency