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These include the following: therapeutic benefits resulting from non-antioxidant mechanisms, insufficient dosage to elicit an antioxidant effect, poor oral bioavailability, a narrow therapeutic index, or toxicity that precludes clinical use

Downregulation of ceramide synthase 1 promotes oral cancer through endoplasmic reticulum stress

This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur

95% CI: 0.42, 0.28