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Treatment should start urgently and should not be delayed for laboratory confirmation if neurological features strongly suggest B12 deficiency

Given the fact that vitamin B12 levels were increased insignificantly among all routes, the preference of the administrated route should be referenced to the advantages and disadvantages of each route as well as the patient situation, which will be decided according to the physicians opinion

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Regular reassessment with healthcare providers helps determine the ongoing need for treatment, with consideration of factors such as treatment response, side effects, and changes in health status or treatment goals