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## **Documentation requirements** Documentation should include: - The diagnosis or condition showing low serum vitamin B12, pernicious anemia, or other diseases classified by B-group deficiencies

I continue to take methotrexate and more recently added hydroxychloroquine

The tests high sensitivity may also amplify residual RNA from past infections or low viral loads that do not indicate active disease

This deficiency may compromise skin cell health and increase oxidative damage

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If you have the injection when you have significant weakness in the muscles of the shoulder, or significant tightness in the shoulder cortisone will either have no effect, or a moderate short term effect only