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Labs indicated severe macrocytic anemia, thrombocytopenia, decreased B12 level with elevated methylmalonic acid, and elevated homocysteine
Conditions include alcoholic liver disease, viral hepatitis, cirrhosis, and primary or metastatic liver cancer Renal dysfunction : Impaired kidney function reduces B12 elimination, causing accumulation even with normal intake Haematological conditions : Myeloproliferative neoplasms, chronic myeloid leukaemia, polycythaemia vera, and hypereosinophilic syndrome increase transcobalamin production, elevating total serum B12 Laboratory interference : Macro-B12 (immunoglobulin-bound B12) and assay interference can cause spuriously elevated results without true excess In clinical practice, unexplained hypercobalaminaemia should prompt investigation for underlying disease, particularly in patients without obvious supplementation history
Influence of the N-methyl-D-aspartate antagonist memantine on human motor cortex excitability
San Martin et al., 2007)
It doesn't spike cortisol or prolactin like some GHRPs, and its effects on lipid metabolism and body recomposition are clinically validated
