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In addition, combination of NNMTi with exercise further increases systemic energy expenditure, accelerates fat breakdown, and enhances muscle strength and endurance

They may arrange blood tests to evaluate: Inflammatory markers (ESR, CRP) to detect active inflammation Rheumatoid factor and anti-CCP antibodies if inflammatory arthritis is suspected Full blood count to assess haematological response to B12 treatment Thyroid function tests , as thyroid disorders commonly coexist with B12 deficiency Note that serum B12 levels are not typically measured to assess treatment adequacy once replacement therapy has begun, as they may not reliably reflect tissue stores

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