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If the result of the primary test is low, they should diagnose vitamin B12 deficiency

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Older cats with intestinal, pancreatic, or hepatobiliary disease or in an anorexic state are at greater risk of cobalamin deficiency, because serum cobalamin concentration physiologically decreases with age [39]

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Megaloblastic anemia Diminished activity of methionine synthase in vitamin B 12 deficiency inhibits the regeneration of tetrahydrofolate (THF) and traps folate in a form that is not usable by the body ( Figure 3 ), resulting in symptoms of folate deficiency even in the presence of adequate folate

Beyond weight loss, early exploratory data suggest potential benefits including: Reductions in HbA1c (a marker of blood sugar control) in people with type 2 diabetes Improvements in lipid profiles (cholesterol and triglycerides) Reductions in liver fat, which may be relevant for metabolic dysfunction-associated steatotic liver disease (MASLD, formerly NAFLD), though these findings are preliminary Possible cardiovascular benefits