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Together, they sharply raise reflux risk

HCG and Fetal Leydig Cell Development Research Research has confirmed that hCG plays a larger role than fetal pituitary LH in testosterone production by Leydig cells during early fetal development, with the LHCGR not detected in fetal Leydig cells until 1012 weeks after conception

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By preventing blood sugar spikes and crashes, it also helps reduce energy fluctuations and cravings

The diagnostic process typically involves: Clinical history taking, focusing on symptoms (fatigue, neurological changes, dietary habits) Physical examination for signs of anaemia or neurological impairment Blood tests including full blood count, serum B12, and often folate levels Additional investigations such as intrinsic factor antibodies or parietal cell antibodies if pernicious anaemia is suspected For borderline results, additional tests like holotranscobalamin (active B12) may be considered NICE guidance recommends that treatment should commence based on clinical presentation if neurological symptoms are present, without waiting for laboratory confirmation, as delays can result in irreversible nerve damage