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Diagnosis typically involves B12 level testing, intrinsic factor antibody tests, and sometimes specialized absorption studies like the Schilling test

Very few cases of side effects of Alamin SN on the liver have been reported

For hematocrit and reticulocyte counts, recommendations are to repeat these tests daily from the 5th to 7th days of treatment and then frequently until the hematocrit returns to a normal range.[9][16][22] Both serum potassium concentrations and the platelet count need to be monitored carefully after parenteral administration of cyanocobalamin

A large 2026 study found that colon cancer patients with very high B12 levels survived a median of around five years, compared with nearly eleven years for those with normal levels