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New England Journal of Medicine , 251 (5), 161168

Animal studies have explored its effects on gastric ulcer models, inflammatory bowel conditions, and intestinal anastomosis healing, with researchers observing notable cytoprotective responses in mucosal tissue models

This combination is widely studied in laboratory settings for synergistic effects on tissue repair, recovery, and regenerative pathways

Recommended investigations include: Full blood count with blood film examination Serum vitamin B12 level Serum folate (to exclude combined deficiency) Intrinsic factor antibodies Thyroid function tests (autoimmune association) Consider MMA and homocysteine if diagnosis uncertain and available Neurological examination should be performed in all patients, assessing for peripheral neuropathy, proprioception loss, and signs of subacute combined degeneration of the spinal cord

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