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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)

Some have FDA approval for very specific conditions (e.g., tesamorelin for HIV-related lipodystrophy), but using them outside of that is considered off-label

Doctors should understand these to help patients deal with insurance issues

This leads to poor B12 absorption, even in those who consume sufficient dietary sources[11]

The ideal approach depends on individual circumstances