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[10] Initial assessment involves: Detailed medical history, including dietary habits and gastrointestinal symptoms Medication review (certain drugs like metformin and proton pump inhibitors can affect B12 absorption) [20] [21] Family history of pernicious anaemia or autoimmune conditions Physical examination for signs of anaemia or neurological abnormalities Laboratory investigations typically include: Serum vitamin B12 level: The primary test, though interpretation can be complex

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So how do they vary

Glossitis (inflamed, smooth tongue) and angular cheilitis are characteristic mucocutaneous findings

Given the concern about ADE, and the remarkably broad additional potential immune-protective function of antibodies in controlling inflammation, it is critically important that vaccines will be evaluated for their pro-inflammatory and anti-inflammatory antiviral Fc functional profiles to maximize the true potential of the humoral immune system