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When serum B12 results are equivocal or clinical suspicion remains high despite normal B12 levels, additional tests may be requested: Methylmalonic acid (MMA) : Elevated levels indicate functional B12 deficiency at the cellular level, though availability may be limited in primary care and levels can be elevated in renal impairment Homocysteine : Also elevated in B12 deficiency, though less specific and also affected by renal function Intrinsic factor antibodies : To investigate pernicious anaemia, the most common cause of B12 deficiency in the UK Anti-parietal cell antibodies : May be tested if pernicious anaemia is suspected but intrinsic factor antibodies are negative Identifying the underlying cause is crucial for appropriate management

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6A), forming conventional hydrogen bonds with ASP-177 and TYR-224

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Finally, we developed a toolkit that organized and displayed the data we had generated

J Environ Sci 17:177180 Cheng J, Yang Y, Ma J, Wang W, Liu X, Sakamoto M, Qu Y, Shi W (2009) Assessing noxious effects of dietary exposure to methylmercury, PCBs and Se coexisting in environmentally contaminated rice in male mice