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This was best summed up in a BMJ editorial last year, which noted that diagnosing B12 deficiency can be "challenging" because no "single specific measurement exists to reliably diagnose or refute the presence of B12 deficiency"

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For instance, ineffective mitophagy leads to increased ROS production and the accumulation of mitochondrial DNA in the cytoplasm, which enhances the activation of caspase-1 and IL-1

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10.1371/journal.pone.0065860 83 ZhouT.ZhangZ.LuoF.ZhaoY.HouX.LiuT.et al (2020)