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Medical supervision plays a vital role since both methods affect hydration and electrolyte balance

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1,2 Although not clinically validated or available for widespread use, measurement of holotranscobalamin, the metabolically active form of vitamin B 12 , is an emerging method of detecting deficiency

Competing Interests Professor Melanie Davies has acted as a consultant/advisor and speaker for Eli Lilly, Novo Nordisk and Sanofi, has attended advisory boards for Abbvie, Amgen, AstraZeneca, Biomea Fusion, Carmot/Roche, Sanofi, Zealand Pharma Regeneron, GSK and EktaH and as a speaker for AstraZeneca and Boehringer Ingelheim