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These include decreased energy levels, muscle loss, weight gain, and weaker bone density, just to name a few

& Avery, S

See this article if you want to learn more about the differences between these different forms

[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

Cysteine is released from extracellular glutathione by -glutamyl-transferase (GGT) located on the apical surface of the kidney, intestine and the epithelia of most transporting ducts, including the liver and bile ducts [37]