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They use blood tests to check Vitamin B12 levels
Birn H, Zhai X, Holm J, Hansen SI, Jacobsen C, Christensen EI, Moestrup SK

In a population-based cohort study, the burden of MRI T2 hyperintensities in the white matter correlated with biochemical indices of relative vitamin B12 deficiency, even when these indices were in the generally accepted normal range (63)

Metabolic syndrome and the risk for chronic kidney disease among nondiabetic adults

The volume, color, and consistency of any synovial fluid aspirated, plus whether specimens went to the laboratory and which specific tests were ordered
