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GPs can prescribe B12 injections following appropriate investigation, which should include: Full blood count to identify macrocytic anaemia Serum B12 and folate levels to confirm deficiency (using laboratory-specific reference ranges) Methylmalonic acid and/or homocysteine when B12 results are borderline Intrinsic factor antibodies if pernicious anaemia is suspected Additional tests depending on clinical presentation (e.g., thyroid function, coeliac serology) When both B12 and folate deficiency are present, B12 should be replaced before folate to avoid precipitating subacute combined degeneration of the spinal cord

In the liver, these transporters play a role in the movement of cholesterol and plant sterols into the bile facilitating the excretion of sterols

doi: 10.1126/scitranslmed.3007218 35 FinanBYangBOttawayNSmileyDLMaTClemmensenCet al

ALCAR has an additional acetyl group, which changes its chemical structure and facilitates its crossing of the blood-brain barrier

Seek urgent care for severe abdominal pain, serious allergic symptoms or signs of dehydration