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22,23 In patients with a normal or low-normal serum vitamin B 12 level, complete blood count results demonstrating macrocytosis, or suspected clinical manifestations, a serum methylmalonic acid level is an appropriate next step 1,2,6,18 and is a more direct measure of vitamin B 12 's physiologic activity

Over-the-counter oral antihistamines can help with itching, and a cool compress reduces heat and swelling

Oral Contraceptives: Certain birth control pills may lower the blood levels of Vitamin B6 and B12, requiring careful monitoring during supplementation

For adults over 19, the recommended daily intake (RDI) is 2.4 micrograms (mcg)