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Ask for serum B12 and consider MMA if results fall into a borderline range

Anemia-Related Symptoms Fatigue Weakness Muscle weakness Pale/yellowed skin Rapid heartbeat Heart palpitations Shortness of breath Swollen/sore/smooth tongue Headaches Nausea Diarrhea Indigestion Incontinence Appetite problems Weight gain or weight loss Dizziness or faint feeling Nerve-Related Symptoms Nerve problems, such as tingling or numbness Mental health issues, such as depression Memory loss Dizziness Confusion Dementia Imbalance/trouble walking or standing Irritability Vision loss What Causes B12 Deficiency

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14,15 Disc/endplate specimens from small animals can be cultured without losing cell phenotype for up to 4 weeks