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High-Risk Profiles The threshold for testing should be lower if the individual falls into any of these categories: Age 60 or older Long-term use of metformin or proton pump inhibitors (PPIs) Strict vegetarian or vegan diet Family history of pernicious anemia or autoimmune disease Key Clinical Symptoms Neurological and cognitive: tingling, numbness, or a "pins and needles" sensation in the hands or feet

Breast Cancer Res Treat 2012;132(1):175187

it competitively binds to cellular receptors, blocking the body's natural active B6 and potentially inducing a functional deficiency that leads to peripheral neuropathy (nerve tingling and pain)

Injectable steroids can cause blood glucose readings to rise soon after administration and the effects may last from three to 10 days

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