[1] [13] When B12 levels are borderline or clinical suspicion remains high despite normal B12, additional tests include: Holotranscobalamin (active B12) , which may be more sensitive in early or borderline deficiency Methylmalonic acid (MMA) and homocysteine levels, which become elevated in functional B12 deficiency (note that MMA is also elevated in renal impairment, and homocysteine rises in folate and B6 deficiency) Full blood count to identify macrocytic anaemia (elevated mean cell volume) Blood film examination may show hypersegmented neutrophils and megaloblastic changes Serum folate should be checked concurrently, as deficiencies often coexist Investigating the underlying cause is essential for appropriate management
Journal of Chromatography B, 1235, 124033
Giannaccare, G., Pellegrini, M., Senni, C., Bernabei, F., Scorcia, V., & Cicero, A
Acute haemolysis due to naphthalene inhalation
Claims about its effects on skin health or immune function are still being studied and are not currently supported by FDA-approved uses
Science 362 , 956960 (2018)
