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Sports Med 46(11):1689-1697

[1] [13] When B12 levels are borderline or clinical suspicion remains high despite normal B12, additional tests include: Holotranscobalamin (active B12) , which may be more sensitive in early or borderline deficiency Methylmalonic acid (MMA) and homocysteine levels, which become elevated in functional B12 deficiency (note that MMA is also elevated in renal impairment, and homocysteine rises in folate and B6 deficiency) Full blood count to identify macrocytic anaemia (elevated mean cell volume) Blood film examination may show hypersegmented neutrophils and megaloblastic changes Serum folate should be checked concurrently, as deficiencies often coexist Investigating the underlying cause is essential for appropriate management

Most are given as small injections under the skin

doi: 10.2147/vhrm.2006.2.3.213

562 Data from the National Health and Aging Trends Study indicated that caregivers of people living with dementia are more likely than caregivers of people without dementia to provide help with selfcare and mobility (85% versus 71%) and health or medical care (63% versus 52%)

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