If there is a lack of cobalamin in the body, methylmalonyl CoA accumulates, which presumably leads to the neurological manifestations of B12 deficiency.[4][7][9][12] The replenishment with parenteral cyanocobalamin causes a rapid and complete improvement of megaloblastic anemia and gastrointestinal symptoms caused by vitamin B12 deficiency
However, if you do have blood work done note that the drawback is that the current widely used test to check B12 levels only measures the total amount o vitamin B12 in your blood, meaning, it measures the forms of active B12 which your body can use and process as well as the inactive forms which cannot
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