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Herein, we discuss three aspects of the assessment of B 12 status: (1) The utility of metabolites used as biomarkers of vitamin B 12 deficiency in neonates and adults, (2) The algorithms employed to predict subclinical and clinical B 12 deficiency, and (3) Major challenges and diagnosis of vitamin B 12 deficiency in special populations

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Vitamin B12 is water-soluble, and the body excretes excess amounts through urine rather than storing supraphysiological levels

Metabolic rate (influenced by thyroid function, body composition, and physical activity) also modulates drug clearance, with higher metabolic rates potentially shortening half life and lower rates extending it