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Additionally, sublingual B12 bypasses intestinal absorption issues, and is a more accessible treatment option for vitamin B12 deficiency

Reconstitution and draw, step by step The arithmetic above is only half the picture

However, those patients who are AMA negative and thought to nevertheless have PBC need radiographic demonstration of a normal biliary tree on cholangiography, either by magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP), to exclude other possible diagnoses, particularly primary sclerosing cholangitis (PSC)

Cognitive impairment presents in 30% to 50% of patients