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This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur

NAD+ & Cellular Energy By blocking NNMT, 5-Amino-1MQ allows more nicotinamide a building block of NAD+ to be recycled back into the cells energy systems

B12 deficiency can result from dietary factors such as a lack of animal products or from conditions affecting absorption like pernicious anaemia or gastrointestinal surgery

Defective mitochondrial DNA homeostasis in the substantia nigra in Parkinson disease