In my own practice, especially if an older person has risk factors for vitamin B12 deficiency, I consider a vitamin B12 level of 200-400 pg/mL borderline, and I usually order a methylmalonic acid level as a follow-up
This service does not aim to diagnose and/or treat vitamin B12 deficiency
These genes encode for the plasma inflammatory and growth factors previously associated with VCD in long COVID in this cohort 4
Each case is subject to trial and error, though, as not all peptides dissolve easily
Pernicious anemia occurs more commonly in people who already have diseases that are linked to immune-system abnormalities, such as Graves disease, hypothyroidism (under-functioning thyroid gland), thyroiditis (inflammation of the thyroid), vitiligo, and Addison's disease (adrenocortical insufficiency)