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The reported K D values should therefore be interpreted cautiously until the experimental details are clarified or independently reproduced

[7] [9] Patients with a history of oxalate nephrolithiasis (kidney stones) or hyperoxaluria should avoid high-dose vitamin C administration, as ascorbic acid is metabolized to oxalate, which may precipitate stone formation or exacerbate renal impairment

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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