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These last two tests are more costly, but provide the best measure of how our body is using Vitamin B12

Polyminimyoclonus (also called minipolymyoclonus) is a type of involuntary hyperkinetic movement that is often described in patients with anterior horn cell diseases such as amyotrophic lateral sclerosis and brachial monomelic amyotrophy (Hirayama disease) [ 109 ]

If you take any of these regularly, mention it to your doctor when discussing B12 therapy

it reveals predispositions in peptide and metabolic genetic pathways

Some researchers cycle the stack in 6-week on, 4-week off intervals to prevent adaptive downregulation of AMPK or NNMT pathways