Background: Low vitamin B12 (B12) status is common in patient populations. The timely detection and correction of low B12 prevents megaloblastic anaemia and neurological impairment. However, prompt diagnosis is recognised as problematic especially when status is estimated using total B12 abundance in serum as the sole laboratory indicator. Emerging evidence indicates that holotranscobalamin (holoTC), the active fraction of B12, is a more reliable marker. Functional markers of B12 utilisation e.g. elevations in serum methylmalonic acid (MMA) concentration, can complement the assessment of B12 status.
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