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Independent analysis suggests you cannot do so without commissioning your own laboratory testing

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Like with B12, folate deficiency can also cause megaloblastic anemia

But it's not recommended to hold a glass bottle under hot water, as the change in temperature could cause the glass to shatter, especially if the bottle's contents are very cold

A translational review on NNMT inhibitor clinical development ( Emerging opportunities for NNMT inhibitor clinical translation , ScienceDirect, 2026) points out that alternative routes like polyamine biosynthesis could compensate for the raised SAM, and that partial rather than total inhibition might even be preferable specifically to avoid triggering those compensatory mechanisms from a chronically imbalanced SAM/SAH ratio

People taking powerful acid-suppressing drugs called proton pump inhibitors (PPIs) or the diabetes drug metformin may also be vulnerable to a cobalamin deficiency