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22,23 In patients with a normal or low-normal serum vitamin B 12 level, complete blood count results demonstrating macrocytosis, or suspected clinical manifestations, a serum methylmalonic acid level is an appropriate next step 1,2,6,18 and is a more direct measure of vitamin B 12 's physiologic activity

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For doses under 20 units, a 0.3 mL or 0.5 mL syringe with 1-unit markings gives better precision than a 1 mL syringe marked in 2-unit steps

Vegetarians, people who've had weight loss surgery, and anyone taking medications for acid reflux or diabetes are also commonly affected

These beads were chosen because they have been specifically linked to GH's fat-burning (lipolytic) actions