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Methionine It is an essential amino acid which means it cannot be synthesized in our body so we must get it from other sources

Taking high-dose oral B12 supplements can also greatly increase blood levels here, the same period of 7-10 days should be observed before testing

Chronic treatment requirements further complicate therapy, particularly in elderly patients with multiple comorbidities who are highly susceptible to adverse drug reactions and drugdrug interactions (Singh et al., 2024)

Groups at higher risk of deficiency include older adults (due to reduced stomach acid production), people following vegan or strict vegetarian diets (as B12 is naturally found almost exclusively in animal products), individuals with pernicious anaemia or other malabsorption conditions, those taking certain medications such as metformin or proton pump inhibitors long-term, and people with significant nitrous oxide exposure (including recreational use), which can inactivate B12 in the body