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In addition, as an ectoenzyme, CD38 modulates intracellular NAD + concentration, which is critical for maintaining low glycolytic activity that supports cell proliferation and survival [39]

So, you measure a higher B12, but part of that B12 is inactive, so useless Oral B12 supplementation, even in the form of a multivitamin preparation, may result in serum B12 concentrations just within the normal range without abolishing symptoms

Note any concerning symptoms to discuss at follow-up appointments

There is an increased risk of gastric cancer in those with pernicious anemia linked to the common feature of atrophic gastritis

Vitamin B12 is a water-soluble vitamin and is derived almost entirely from certain foods such as meat, fish, shellfish, dairy products, eggs and edible algae

Much of the focus has been on how harmful it is to the body to have too little of the vitamin