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Precautions General The validity of diagnostic vitamin B12 or folic acid blood assays could be compromised by medications, and this should be considered before relying on such tests for therapy

Importantly, B12 deficiency can occur without anaemia, and some patients may present with neurological symptoms despite having normal haemoglobin levels

PMID 17284744

It would come down to the specific company if they got lazy and allowed for something like acid rock drainage to impact the environment

it is a medicine that helps your body make more platelets and is sometimes used in people who are also getting chemotherapy, but it does not treat cancer itself