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Patients with hematologic disorders (polycythemia vera, thrombotic thrombocytopenic purpura) or cyanide sensitivity (rare) need careful provider evaluation before high-dose cyanocobalamin

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2, 2023 from Wilding, J., Batterham, R

note that liver function tests are adjunctive and do not reliably reflect disease severity on their own Note: Measures such as HOMA-IR (a research tool for estimating insulin resistance) are not routinely used in UK clinical practice and are more relevant in a research or trial context

You should establish partnerships exclusively with organisations that have established trustworthiness