Vitamin B 12 (cobalamin) deficiency is a common cause of megaloblastic anemia, a variety of neuropsychiatric symptoms, and elevated serum homocysteine levels, especially in older persons. There are a number of risk factors for vitamin B 12 deficiency, including prolonged use of metformin and proton pump inhibitors.n asymptomatic patients with low-normal levels of vitamin B 12 (200 to 350 pg per mL [147.56 to 258.23 pmol per L]), elevated levels of the precursor compounds homocysteine and methylmalonic acid may prompt a decision to supplement patients with vitamin B 12. 5.
A ham sandwich made with two slices of whole wheat bread, two slices of ham and one leaf of iceberg lettuce contains 220 calories.
If your ham sandwich is built with two slices of white bread, four slices of ham, two slices of cheese, a tablespoon of mayo and a tablespoon of mustard, the sandwich contains 447 calories. The same sandwich on whole-wheat bread has 461 calories. The ham and cheese are significant sources of protein and fat. A single slice of ham has 4.7 grams of protein and 2.4 grams of fat, while a single slice of cheese has 5.2 grams of protein and 1.5 grams of fat. Lose Weight.