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Many patients have undiagnosed low b12 even before medication use, particularly among certain risk groups

[14] This complex consists of the following symptoms: Impaired perception of deep touch, pressure and vibration, loss of sense of touch, very annoying and persistent paresthesias Ataxia of dorsal column type Decrease or loss of deep muscle-tendon reflexes Pathological reflexes Babinski, Rossolimo and others, also severe paresis

International journal of preventive medicine, 11, 4

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In women with confirmed deficiency, milk levels are typically less than 100 pmol/L (135 ng/L).[9,12,39] A lower milk level threshold of 310 pmol/L (420 ng/L) for adequate infant B 12 intake has been suggested.[28] Three mothers in India with vitamin B 12 deficiency due to very low dietary intake were given a single 50 mcg intramuscular injection of vitamin B 12