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The clinical significance arises when B12 is elevated without a clear exogenous explanation

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Vitamin B12 injections are a routine and effective treatment for deficiency or absorption problems

Treatment for B12 deficiency without neurological involvement: For patients with haematological manifestations only (macrocytic anaemia) or asymptomatic deficiency, the regimen is hydroxocobalamin 1mg intramuscularly three times weekly for two weeks (total of six injections), followed by maintenance of 1mg every three months for life