What is elevated in B12 deficiency,”Homocysteine (as in folate)Methylmalonic acidPresent: Sore tongue, neuropathy (loss of position and vibration; urinary and fecal incontinence, impotence)Dx: Megaloblastic anemia
hypersegmented PMNTreat: IV Cyanocobalamin once a month (folate deficiency requires daily supplement; storage only lasts for 3 months)*B12 absorbed in the ileum*Pernicious anemia is auto-Ig against IF”