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By themselves, all these disturbances, which were ameliorated/reduced, are quite severe

At the current presentation he has serum B 12 (209 pmol/L), which is within the normal range (148-600 pmol/L), however MMA is elevated at 1100 nmol/L (a measurement taken in 2017 was 117 nmol/L, normal A) and vitamin B 12 in Europe and West Africa Am J Clin Nutr 2012;95:514-21

42 Gastrointestinal autonomic neuropathy Gastrointestinal autonomic neuropathy affects the enteric nervous system, leading to dysregulation of gastrointestinal motility and function

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Studies on Vitamin B12 and Erectile Dysfunction There is growing interest in the potential link between Vitamin B12 deficiency and erectile dysfunction