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It is important to note that neurological damage can occur before haematological changes become apparent, and symptom severity does not always correlate with the degree of biochemical deficiency
[DOI] [PMC free article] [PubMed] [Google Scholar] 83.Bruse C, Bergqvist A, Carlstrm K, et al
Instead of shaking the vial, swirl it slowly until the powder is completely dissolved, as shaking can damage the delicate peptide structures
Therapeutic response to vitamin B12 may be impaired by concurrent infection, uremia, folic acid or iron deficiency, or by drugs having bone marrow suppressant effects
2016;1:e566
