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After reviewing literature and conducting a two-round Delphi survey with 42 experts, a consensus emerged that emphasizes prioritizing clinical symptoms in diagnosis, with serum B12 as a screening marker supported by methylmalonic acid or homocysteine levels for additional confirmation

However, the exact quantities in fortified foods can vary and plant-based dietary sources alone may not be sufficient to prevent or correct a deficiency (1)

For example, FDA labeling for cyanocobalamin injection includes contraindications (such as hypersensitivity) and important warnings (see the FDA prescribing information for cyanocobalamin injection )

Pneumonia (4%) Pulmonary embolism (3.4%) Congestive heart failure (2.6%) Leak or esophageal injury (2.5%), etc Older patients with multiple comorbidities, smokers and obese patients have a higher risk of complications

Incubation for 10 min at room temperature was performed to ensure complex assembly