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These tests may require specialist laboratory referral Holotranscobalamin (active B12) where available, may be used as a second-line test when standard B12 results are borderline Intrinsic factor antibodies to identify pernicious anaemia, the most common cause in the UK Parietal cell antibodies may be useful if intrinsic factor antibodies are negative but pernicious anaemia is still suspected Thyroid function and folate levels to exclude other causes of similar symptoms According to current UK guidance, patients presenting with neurological symptoms suggestive of B12 deficiency should not have treatment delayed whilst awaiting test results

Zonulin antagonist (known as Larazotide acetate, or AT-1001, or INN-202) was purchased from BOC Sciences, NY, USA or later synthesized by GENAXXON biosciences, Ulm, Germany and effectiveness was compared in one side-by-side experiment using both purchased zonulin antagonist sources (BOC Sciences, NY, USA vs

D., McKay, D., Yang, H., Minaya, C., Montag, C., & Asmundson, G

& Rimes, K

Shivaswamy V, Ochsner L, Maroni D, et al