The reality is nuanced: the clinical significance of elevated B12 depends almost entirely on why its elevated
Later, this condition was called Addisonian anemia, at least until German internist Michael Anton Biermer (1827-1892) in Zurich named it pernicise Anmie (ie, pernicious or fatal anemia) when describing 15 cases of severe anemia (of mixed etiologies) in 1872 (139)
Musculoskeletal tissue models: Investigation of structural signaling pathways
If symptoms are persistent, progressive, asymmetric, severe, or associated with weakness, bowel or bladder dysfunction, gait changes, or other neurological concerns, additional evaluation may be needed
In cases of documented vitamin deficiency, the regimen could be an initial intensive phase (like 2 mL IM three times a week for 2 weeks) followed by reevaluation