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However, hydroxocobalamin is better tolerated by sensitive individuals and those with histamine issues
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In this setting, the CARE B12 group studied in an open study 10 patients with well-documented vitamin B12 deficiency related to pernicious anemia who daily received 1,000 g (1 mg) of oral crystalline cyanocobalamin for at least 3 months [32]
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For patients whose levels fall in the borderline or gray zone, a methylmalonic acid (MMA) test provides greater specificity MMA levels rise when B12 is functionally inadequate at the cellular level, even if serum B12 appears borderline normal
