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Eighteen months to the day of Amanda's diagnosis, in March of 2021, Samantha found herself needing a colonoscopy after a positive noninvasive at-home colorectal cancer screening test from what she believed to be symptoms of hemorrhoids

Specifically, the system consisted of a Thermo Q-Exactive in line with an electrospray source and an Ultimate3000 series HPLC consisting of a binary pump, degasser and auto-sampler outfitted with an Xbridge Amide column (Waters) (dimensions: 3.0 100 mm and a 3.5-m particle size)

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Diagnosis relies on B12 levels, methylmalonic acid, homocysteine, and intrinsic-factor antibodies interpreted by a clinician