B12 is found in animal-derived foods and absorbed in the gut with the help of intrinsic factor, a protein produced by the stomach. Deficiency commonly results from inadequate intake (vegetarian or vegan diets), malabsorption, pernicious anemia, certain medications (such as metformin and acid-suppressing drugs), and aging.
This test is used to evaluate macrocytic anemia, neuropathy, cognitive symptoms in older adults, and to monitor patients on long-term metformin or acid-suppression therapy. B12 is often tested alongside folate, since their deficiencies cause similar findings and may coexist. Sample type is serum.
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