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Symptoms associated with vitamin B12 deficiency include fatigue and lack of energy (due to anaemia), and depression, psychosis and even dementia

Some people describe this as feeling mentally foggy or having trouble staying sharp during tasks that require attention

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Cellular NAD+ levels decline with age and metabolic stress, which has prompted interest in raising them through precursors or direct administration for energy, metabolic and longevity goals [11]

But the consistency of positive reports across different injury types and patient populations is notable

DNA testing required for formal diagnosis (not a first-line investigation, exclude other causes first) Pre-pregnancy carrier testing of partner is important Rare causes of microcytic anaemia Chronic inflammation Lead poisoning (high blood lead level) Sideroblastic anaemia Normocytic normochromic anaemia Haemolytic anaemia Acute haemolysis in childhood can be a life-threatening illness and all cases should be discussed with a haematologist Admit children with haemolytic anaemia for observation