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When serum B12 results are equivocal or clinical suspicion remains high despite normal B12 levels, additional tests may be requested: Methylmalonic acid (MMA) : Elevated levels indicate functional B12 deficiency at the cellular level, though availability may be limited in primary care and levels can be elevated in renal impairment Homocysteine : Also elevated in B12 deficiency, though less specific and also affected by renal function Intrinsic factor antibodies : To investigate pernicious anaemia, the most common cause of B12 deficiency in the UK Anti-parietal cell antibodies : May be tested if pernicious anaemia is suspected but intrinsic factor antibodies are negative Identifying the underlying cause is crucial for appropriate management
Both run 8 to 12 weeks, which is longer than people expect for a skin protocol
BPC-157 and TB-500 are available only through 503A compounding pharmacies under physician prescription
That second pathway explains why prolonged deficiency causes neurological damage and not simply anaemia
Nanoscale Res Lett
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