Conclusion Mild to moderate hyperhomocysteinemia seems to be an independent and causal risk factor for atherosclerotic vascular disease
It is also important to be aware of symptoms that may suggest either worsening B12 deficiency or poorly controlled blood glucose, and to seek prompt medical advice if you experience: Persistent fatigue, breathlessness, or pallor (possible anaemia) Tingling, numbness, or weakness in the hands or feet (possible B12-related neuropathy) Unsteadiness when walking, or changes in memory or thinking (possible signs of more severe B12 deficiency requiring prompt assessment) Increased thirst, frequent urination, or unexplained weight loss (possible hyperglycaemia) If you think you may be experiencing a side effect from a medicine for example, symptoms of B12 deficiency that you believe may be related to metformin you or your healthcare professional can report this via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk
Incidental findings that meet the definition of a reportable diagnosis (affect management, require additional workup or treatment) should be coded per Official Guidelines Section III
Preliminary results for the four cobalamins in this Perspective are very promising, and provide a more in-depth understanding of recent experimental results
