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Some patients with multiple recurrent metabolic disorders may develop irreversible neurological damage with residual mental retardation, ataxia, spastic paraplegia, sensorineural hearing loss, optic nerve atrophy, and epilepsy [79, 81]

To confirm the diagnosis: To confirm a borderline serum test and clarify whether treatment is necessary

They are particularly useful for individuals with pernicious anemia or other conditions that impair Vitamin B12 absorption through the digestive tract

Commit to at least 8-12 weeks before judging effectiveness

Subcutaneous administration of vitamin B12 is sometimes employed, especially in patients with congenital cobalamin metabolism disorders who require high doses to maintain normal metabolic pathways