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In this situation, it can be challenging to demonstrate B12 deficiency even when there are typical symptoms (including neuropathy-like paraesthesia and numbness), as serum B12 concentrations may be just within, or sometimes above, the normal range due to the oral supplementation

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"The adolescent and adult form of cobalamin C disease: clinical and molecular spectrum"

Treatment options can include: Supplements Oral B12 : Effective for most people, even those with mild malabsorption Sublingual B12 : Dissolves under the tongue, dominantly orally with some absorption passing into the bloodsteam Injectable B12: Used in specific cases, for example if someone is not responding to oral or sublingual supplements