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[51] Diagnosis [edit] According to one review: "At present, no 'gold standard' test exists for the diagnosis of vitamin B 12 deficiency and as a consequence the diagnosis requires consideration of both the clinical state of the patient and the results of investigations." [52] The vitamin deficiency is typically suspected when a routine complete blood count shows anemia with an elevated mean corpuscular volume (MCV)

Long-term reactions are still unclear

Unfortunately, vitamin B12 deficiency during infancy results in severe, permanent neurological damage

Despite that risk, there are still easy ways to extend the shelf life of your B12 injections and keep them in good condition long after their expiration date

Overuse can potentially lead to red flags or recoupment