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It may be elevated in hypercalcemia or hypercalciuria and lowered PTH
Methylmalonic acid is a more sensitive marker of functional B12 status Complete blood count (CBC): Establishes baseline red blood cell parameters for monitoring anemia development Iron panel (ferritin, serum iron, TIBC): Ferritin below 30 ng/mL suggests depleted stores even with normal hemoglobin Comprehensive metabolic panel: Includes calcium, magnesium (though serum magnesium is imperfect), and kidney function RBC magnesium: More accurate than serum magnesium
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The volumes are manageable
Some patients have also experienced a hypersensitivity reaction following intramuscular injection that has resulted in anaphylactic shock and death
