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they will likely discontinue the injections to err on the side of safety

Good intentions, on the other hand, might quickly evolve into frustration

Nevertheless, in cases of severe deficiency with neurological sequelae, we suggest that IM B12 is used in the first instance to replenish body stores with the treatment regimen, including dosage and formulation, optimised to keep the patient free of symptoms and tailored to the metabolic response of not only plasma B12 levels, but also confirmatory testing of homocysteine, methionine, and methylmalonic acid levels

What is the most likely cause of her abnormal liver tests

(2023, July 5)