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Of the 9 referred patients, 3 were treated with oral vitamin B 12 replacement therapy, 2 were given vitamin B 12 injection, and 2 were treated with both oral vitamin B 12 replacement and injection

In sheep, for instance, it is produced from cobalt in the rumen (and cobalt is found in most mineral supplements as well as through natural grazing)

Vitamin B12 injections: In cases of severe B12 deficiency, malabsorption issues, or neurological symptoms, injections often emerge as the preferred treatment

If all three are in range, homocysteine is very unlikely to be elevated, and ordering it adds cost without adding useful information