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In some cases, such as in individuals at higher risk and those presenting with symptoms, additional diagnostics may be ordered, including: Electrocardiogram (EKG or ECG) detects abnormalities in the hearts electrical activity and can identify a current or past heart attack 22 Coronary artery calcium (CAC) scoring (see below) 69-71 Other heart and vessel imaging tests, such as 22 : angiography, a type of X-ray that uses a dye to visualize arteries cardiac magnetic resonance imaging (MRI) to detect tissue damage or altered coronary blood flow cardiac positron emission tomography (PET) to help visualize blood flow in the small arteries of the heart ankle-brachial index (ABI) test to diagnose peripheral artery disease stress test to assess the hearts ability to respond to and recover from physical stress, such as exercise 5 Cardiovascular Risk Assessment Cardiovascular risk assessment is a crucial part of cardiovascular health maintenance

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Human research demonstrated that methylcobalamin supplementation in patients with inadequate B12 levels improved CD4/CD8 ratio and NK cell activity, and augmented CD3-CD16+ cells, suggesting an important role in cellular immunity.[14] In other research, among homologues studied, methylcobalamin was shown to have the strongest antibody production enhancement on an in vitro system.*[15]

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