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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)

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Without enough Vitamin B12, DNA making is off, causing cell division problems

Methionine helps keep fat from accumulating in the liver, inositol and choline help move fat out for the body to use as energy, and methylcobalamin the active form of B12 supports the metabolism of fats, proteins, and carbohydrates