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doi: 10.7759/cureus.74559, 20

That distinction matters

This effect is not guaranteed and may be due to placebo effect

One of the possible reasons that anaemia is much less prominent in B12 deficiency than lets say 30 years ago, is that many countries have started mandatory fortification of food with folate

Vitamin B12 is vital for healthy fetal development and maternal well-being during pregnancy and lactation, but dosing and administration must be individualized based on professional medical guidance

The biomarker methylmalonic acid in urine is sensitive, detecting early functional vitamin B12 deficiency before the onset of macrocytic anemia, as noted for MMA in serum