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Additionally, chronic conditions such as HIV and tuberculosis have been implicated in B12 deficiency due to increased metabolic demand and altered absorption mechanisms ( The diagnosis of vitamin B12 deficiency typically relies on low total B12 levels and elevated concentrations of homocysteine (Hcy), as well as levels of transcobalamin-bound B12 (holoTC) and methylmalonic acid (MMA), which serve as functional indicators of cobalamin insufficiency ( Vitamin B12 requirements fluctuate throughout the life course, influenced by metabolic demand and physiological changes

When dermal papilla cell populations decline or lose function, hair production weakens

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It is approved specifically for visceral adiposity associated with HIV-related lipodystrophy, but the clinical data on its mechanism extends beyond that narrow indication