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They may arrange blood tests to evaluate: Inflammatory markers (ESR, CRP) to detect active inflammation Rheumatoid factor and anti-CCP antibodies if inflammatory arthritis is suspected Full blood count to assess haematological response to B12 treatment Thyroid function tests , as thyroid disorders commonly coexist with B12 deficiency Note that serum B12 levels are not typically measured to assess treatment adequacy once replacement therapy has begun, as they may not reliably reflect tissue stores

Besides B12 deficiency, patients who have pernicious anemia or the nervous system disorder is known as myelopathy can benefit from B12 shots

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GP texted daughter to say script for B12 supplements at pharmacy from specialist, with no discussion or advice but the meds were for 50 mcg, nowhere near enough to bring her levels up which have dropped to 189