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The diagnosis of vitamin B12 deficiency typically relies on low total B12 levels and elevated concentrations of homocysteine (Hcy), as well as levels of transcobalamin-bound B12 (holoTC) and methylmalonic acid (MMA), which serve as functional indicators of cobalamin insufficiency (Carmel and Sarrai, 2006)

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Oral absorption is considered too undependable to rely on in patients with pernicious anemia or other conditions resulting in malabsorption of vitamin B12

[DOI] [PMC free article] [PubMed] [Google Scholar] 82.Zhu, Y., Liu, J., Park, J., Rai, P