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Description
Complete Blood Count (CBC) This test, when it reveals the red blood cells to be very large, can indicate megaloblastic anemia, which is caused by a B12 and/or folate deficiency (18)

Resources Niklewicz A et al

Moreover, this condition leads to a low level of intrinsic factor, a protein that prevents vitamin B12 deficiency
High-dose supplementationparticularly intramuscular injections that can deliver 1,000 micrograms or morecreates substantially elevated serum B12 levels compared to dietary intake, which may more readily trigger these bacterial changes, though comparative studies between different forms are limited

That's the rule, and it doesn't change based on payer

An error at any step cascades through the rest
