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It emphasises the importance of recognising a wide range of symptoms and signs that could indicate a deficiency - including cognitive difficulties, such as: Eyesight problems Mental health issues Neurological/mobility problems Unexplained fatigue The guidelines highlight the necessity for an initial diagnostic test for suspected vitamin B12 deficiency, utilising either total B12 or active B12 tests, (unless specific circumstances require an alternative approach)

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Guo RM, Xu WM, Lin JC, Mo LQ, Hua XX, Chen PX, Wu K, Zheng DD, Feng JQ (2013) Activation of the p38 MAPK/NF-B pathway contributes to doxorubicin-induced inflammation and cytotoxicity in H9c2 cardiac cells