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When investigating elevated B12, additional tests such as active B12 (holotranscobalamin), methylmalonic acid, and homocysteine may help clarify true B12 status

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[20] Treatment of megaloblastic anemia with concurrent vitamin B 12 deficiency using B 12 vitamers (including cyanocobalamin), creates the possibility of hypokalemia due to increased erythropoiesis (red blood cell production) and consequent cellular uptake of potassium upon anemia resolution