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When Re-Testing May be Appropriate Borderline levels: 36 months High levels: 13 months During B12 therapy: Monthly until normalized With new symptoms: As needed Additional Testing Your Doctor May Consider Complete B12 panel Kidney function Absorption testing When Additional Care May be Warranted Persistent high MMA despite supplementation Progressive neurological symptoms Symptoms of severe B12 deficiency (extreme fatigue, difficulty walking) Signs of pernicious anemia (severe macrocytic anemia) Bibliography References 1

Hepatocellular hypertrophy (synonym = hepatocytomegaly) refers to an increased size of hepatocytes (total hepatocyte size, including nucleus and cytoplasm), but not an increased number of hepatocytes