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[51] Diagnosis [edit] According to one review: "At present, no 'gold standard' test exists for the diagnosis of vitamin B 12 deficiency and as a consequence the diagnosis requires consideration of both the clinical state of the patient and the results of investigations." [52] The vitamin deficiency is typically suspected when a routine complete blood count shows anemia with an elevated mean corpuscular volume (MCV)

They do not substitute for one

That distinction is important

Injectable forms avoid potential gastrointestinal interactions but require proper sterile technique

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