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[1] [13] When B12 levels are borderline or clinical suspicion remains high despite normal B12, additional tests include: Holotranscobalamin (active B12) , which may be more sensitive in early or borderline deficiency Methylmalonic acid (MMA) and homocysteine levels, which become elevated in functional B12 deficiency (note that MMA is also elevated in renal impairment, and homocysteine rises in folate and B6 deficiency) Full blood count to identify macrocytic anaemia (elevated mean cell volume) Blood film examination may show hypersegmented neutrophils and megaloblastic changes Serum folate should be checked concurrently, as deficiencies often coexist Investigating the underlying cause is essential for appropriate management

The National Institutes of Health points out that these factors can make it difficult to maintain healthy levels through diet alone, which is why its so important to be aware of your personal risk

Since B12 is water-soluble, excess amounts are excreted through urine rather than stored in the body, reducing the risk of toxicity

Sustainable weight loss comes from a balanced diet, regular exercise, and healthy habits