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Functional and confirmatory markers Methylmalonic acid (MMA), homocysteine, and holotranscobalamin can provide information that total B12 does not

Nicotinamide (niacinamide) does not cause flushing and has fewer side effects, with nausea and liver toxicity reported only at very high intakes ~3 g/day)

Post-treatment serum B12 measurements can be misleadingly high and may not accurately reflect tissue levels, so your GP will focus on symptom improvement and clinical assessment

Its also helpful to select a product thats third-party tested for purity and potency

You can find it in animal products like meat, fish, and dairy