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This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur

Kim CK, Rivier CL

The inclusion of benzyl alcohol helps reduce contamination risk during multiple withdrawals while supporting long-lasting usability under appropriate handling conditions

For example, the researchers conducted experiments with cartilage cells and noted that FOXO4-DRI [may] remove the senescent cells in PDL9 chondrocytes

Karlskas IL, Maudal K, Axelsson L, Rud I, Eijsink VG, Mathiesen G (2014) Heterologous protein secretion in lactobacilli with modified pSIP vectors

Impaired hepatic clearance may also contribute to elevated B12 levels