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LC-MS confirms N-terminal Tyr intact
This option is best suited for those who are comfortable working with typical research-grade variability
When deficiency is suspected based on clinical features (fatigue, paraesthesia, cognitive changes) or risk factors (vegan diet, gastric surgery, certain medications), serum B12 measurement guides appropriate intervention
Indications and Usage for Cyanocobalamin Cyanocobalamin is indicated for vitamin B 12deficiencies due to malabsorption which may be associated with the following conditions: Addisonian (pernicious) anemia Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy Fish tapeworm infestation Malignancy of pancreas or bowel Folic acid deficiency It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see Drug Interactions), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue
