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You may need multiple tests in order to assess if your supplementation plan is working and your B12 levels are improving

This localized hypoxia (lack of oxygen) forces cells to switch to anaerobic energy production, generating excessive lactic acid and causing rapid, severe muscle fatigue even after minimal physical exertion

The PNMT encoded enzyme is also involved in the synthesis of several of the trace amine neurotransmitters

The associated phenotype includes fibrosis, cholestasis, jaundice, bile duct proliferation, and elevated GT and ALP

Here is what we know, what we do not know, and where the gaps are