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A major issue is that the test must be done prior to treatment with pharmacological doses of the vitamin, and thus the patient may display a temporary B12 malabsorption caused by an intestine suffering from the lack of B12

I know I should be thinking more about having such a small amount when lots here feel one every 2 weeks for 4 then every 3 months is not enough

Tissue-level deficiency of cobalamin is associated with an increase in the urinary and serum concentrations of an organic acid called methylmalonic acid, which is an alternative product of a cobalamin dependent pathway within the mitochondria