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[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

Heart and circulatory physiology (2014) Sosne G, Ousler GW Clinical ophthalmology (Auckland, N.Z.) (2015) Ruff D, et al

Using Walshs absorption formula (described here), the EFSAs AI works out to a target absorption of 14.9 g per week from food

Glutathione enhances white blood cell activity, while B12 ensures optimal production of red and white blood cells