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A serum level can appear normal while MMA is elevated, indicating that B12-dependent reactions are not running properly at the cellular level

Initially, frequent injections may be required to build up a sufficient store of vitamin B12

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Patients should seek medical attention for persistent right upper quadrant or epigastric pain, fever, or jaundice

Fortified foods like nutritional yeast, plant-based milks, and cereals can help, but the B12 content in these products can vary quite a bit