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In these cases, your doctor may request additional tests to assess functional B12 status: Methylmalonic acid (MMA) : Elevated levels suggest tissue B12 deficiency, as B12 is required to metabolise MMA (note that renal impairment can also raise MMA levels) Homocysteine : Raised homocysteine can indicate B12 or folate deficiency (also affected by renal function) Holotranscobalamin (active B12) : Measures the biologically active fraction of B12 [4] [8] Full blood count : May reveal macrocytic anaemia (enlarged red blood cells) characteristic of B12 deficiency If B12 deficiency is confirmed, your doctor will likely investigate the cause with tests such as intrinsic factor antibodies (and sometimes parietal cell antibodies) to check for pernicious anaemia, or coeliac serology if malabsorption is suspected

In fact, some popular vegan websites and publications hold the philosophy that vegans can meet all of their essential nutrient needs without the use of any supplements

Generation Scotland received core support from the Chief Scientist Office of the Scottish Government Health Directorates (CZD/16/6) and the Scottish Funding Council (HR03006) and is currently supported by the Wellcome Trust [216767/Z/19/Z]

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Less common, but more serious risks include: formation of abscess infection redness, swelling, warmth or drainage damage to tissues, nerves, blood vessels, or bones hemorrhage, especially in people with bleeding disorders If you notice any unusual side effects or signs of an infection, promptly notify your physician.

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