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.
An average grilled cheese and ham sandwich contains about 310 calories, notes the My Fitness Pal website. One grilled cheese and ham sandwich contains 28 g of fat, 46 mg of cholesterol, 1,127 mg of sodium, 22 g of protein, 5 g of sugars, 5 g of dietary fiber and 26 g of carbohydrates, according to My Fitness Pal. The ham and bread provide the minerals calcium, iron, magnesium, phosphorus, potassium and selenium.