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The clinical picture is the most important factor in assessing the significance of results of blood tests assessing cobalamin (B 12 ) status because there is no gold standard test to define deficiency Neurological symptoms resulting from B 12 deficiency may take several months or even years to resolve completely Measuring serum biomarkers such as B 12 or methylmalonic acid is neither helpful nor indicated in assessing or monitoring clinical improvement, neither is titration of injection frequency based on biomarker assessment Self-administration of intramuscular B 12 injections can lead to greater patient satisfaction and better health outcomes What is vitamin B 12

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[DOI] [PMC free article] [PubMed] [Google Scholar] References to other published versions of this review VidalAlaball 2005 VidalAlaball J, Butler CC, CanningsJohn R, Goringe A, Hood K, McCaddon A, et al

This rebound effect happens as appetite regulation pathways are restored

Management: o Avoid combining with other Vitamin B supplements unless advised by a doctor