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Low holotranscobalamin II or elevated MMA levels despite taking vitamin B12 supplements consistently is an indication youll need to discuss an alternative plan of action with your physician or plant-based dietitian

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Check out this paper from 1992: If the indiscriminate dumping of industrial cyanide waste continues unchecked with the inherent risk of pollution of food and water supplies there may well come a time when more widespread chronic cyanide neurotoxicity occurs in the Western hemisphere from a dietary source in persons with a genetic or acquired error of cyanide or vitamin B12 metabolism

Testing for intrinsic factor antibodies (highly specific for pernicious anaemia) and gastric parietal cell antibodies (more sensitive but less specific) helps confirm autoimmune aetiology

The JAK-STAT pathway regulates CD38 on myeloma cells in the bone marrow microenvironment: therapeutic implications

There was no occurrence of skin infection associated with repeated intradermal injection