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Conclusion Whilst severe B12 deficiency has a clear clinical picture with characteristic haematological and/or neurological features, establishing mild or borderline deficiency can be problematic as serum levels are maintained at the expense of tissue concentrations, and therefore serum levels of B12 may be in the low normal or borderline range despite a deficiency

Researchers are exploring its influence on everything from tendon and ligament healing to gut health and inflammation

10.1016/0011-393x(95)85135-6 62 YazakiY.ChowG.MattieM

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They represent rescue treatment for breakthrough symptoms rather than management strategy