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In such patients, it is necessary to try to establish whether there is significant cobalamin deficiency, e.g., by careful examination of the blood film, tests for serum gastrin level and for antibodies to IF or parietal cells, along with serum methylmalonic acid (MMA) measurement if available

It is also best to only mix up as much as you need in the very short term as very thinned out paints can develop mold since the overall pH starts to move towards neutral and the biocides that were originally added have become too diluted to be effective

Here are clear, honest answers to some of the most common concerns we hear from patients

Cold-chain delivery for injectables

Mutations in ABCD4 cause a new inborn error of vitamin B12 metabolism