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Monitoring the red blood cell count is essential to getting the right treatment

The latter is the first macrocyclic intermediate common to heme, chlorophyll, siroheme and B 12 itself

MIC B12 is typically contraindicated during pregnancy and lactation without explicit obstetric approval

Choline depletion results in decreased fat metabolism and utilization

8 Where results are unclear, serum MMA and homocysteine levels (both of which accumulate with B12 deficiency as discussed above) can also be used to confirm a diagnosis, although homocysteine is not specific to B12 deficiency, as it may also be caused by deficiencies in other B vitamins