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routine B12 level monitoring is generally unnecessary once replacement is established, as levels do not reliably correlate with tissue stores Important safety considerations: Older adults may have impaired renal function, though this rarely affects B12 therapy given its wide safety margin

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Supplementation or approaches that increase endogenous synthesis, such as N-acetylcysteine, glycine, and cysteine availability, demonstrate measurable improvements in oxidative stress markers and, in some studies, improved fertilization outcomes

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Susceptibility loci largely overlap with the loci detected in other complex immune diseases affecting different organs: PSC and PBC shared common risk loci with multiple sclerosis, celiac disease, inflammatory bowel disease (IBD), rheumatoid arthritis and type 1 diabetes (Mells et al., 2013)