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For patients whose levels fall in the borderline or gray zone, a methylmalonic acid (MMA) test provides greater specificity MMA levels rise when B12 is functionally inadequate at the cellular level, even if serum B12 appears borderline normal

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And in blood vessels that are already less flexible or have cholesterol plaques, reintroducing estrogen in the form of hormone replacement therapy can increase the force and speed of blood flow with each heartbeat, sometimes causing a plaque in a vessel to break off and raising the risk of serious problems like heart attack, stroke, or blood clots, says Chervenak

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These include Merck KGaA, which is spending 70 million (58 million) to triple the capacity of its ADC facility in St Louis, US (in addition to a new plant in South Korea), and Lonza, which is doubling capacity in Visp, Switzerland

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