From a laboratory medicine perspective, the Association for Clinical Biochemistry and Laboratory Medicine (ACB) and the Royal College of Pathologists (RCPath) advise that: HbA1c may be unreliable in the presence of haemolytic anaemia, haemoglobinopathies, or nutritional deficiencies affecting red cell biology and the direction of distortion may be high or low Clinicians should document any known haematological conditions when requesting HbA1c, so laboratory staff can flag potential inaccuracies Serum B12 testing should be considered in patients on long-term metformin who are symptomatic or have risk factors for deficiency, in line with MHRA and NICE advice Alternative tests fasting plasma glucose, OGTT, or interim use of fructosamine/glycated albumin should be considered when HbA1c reliability is in doubt The NHS website (nhs.uk) provides patient-facing information on the HbA1c test and factors that can affect its accuracy, which patients may find a useful starting point
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B12 KITX1 Vitamin B12 Self Injection Home Kits How do they work
Digestive issues such as Crohn's or celiac disease can lead to impaired absorption of nutrients in the gut which may result in the need for B12 supplementation
Vitamins B1, B6 and B12 are secreted into human breast milk, but risks of overdose for the infant are not known
With growing evidence on synergy, it's a promising tool for healthspan extension
