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Given that around 25% of the total serum VB12 exists in its active form of holotranscobalamin, it is essential to identify individuals with functional B12 deficiency, particularly those with low-normal circulating B12 levels

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The presence of high serum bicarbonate could indicate chronic respiratory acidosis [typical of chronic obstructive pulmonary disease (COPD)] or metabolic alkalosis (secondary to vomiting, use of thiazide diuretics, or excess mineralocorticoids) (336)

Vitamin B12 is an essential nutrient that plays a role in energy production, brain health, and red blood cell formation