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A rare but clinically significant manifestation is pseudo-thrombotic microangiopathy (PTMA), which closely resembles true thrombotic thrombocytopenic purpura (TTP), characterized by hemolytic anemia, thrombocytopenia, the presence of schistocytes, and elevated lactate dehydrogenase (LDH) levels [2]

The Y -axis is the peak area ratio [ A (CNCbl)/ A ([ 15 N 13 ]-CNCbl)], and the X -axis is the molar ratio [n(CNCbl)/n([ 15 N 13 ]-CNCbl)] ranging between 0.01 and 115.61

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Patients may notice reduced fatigue and improved wellbeing within two to four weeks, whilst macrocytic anaemia typically resolves over six to eight weeks

These studies compared daily oral doses of 1,0002,000 mcg of cyanocobalamin to traditional intramuscular (IM) injections

More serious deficiencies have the potential to impair heart and neurological function, leading to a wide range of serious symptoms, including but not limited to tinnitus, severe joint pain, memory problems, depression, anxiety, poor muscle function, ataxia and changes in reflexes