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Haematological symptoms are among the earliest manifestations and include: Fatigue and generalised weakness Pallor due to anaemia (which may be macrocytic, though this is not universal) Shortness of breath on exertion Palpitations or tachycardia Neurological symptoms can be particularly concerning and may include: Peripheral neuropathy with tingling, numbness, or burning sensations in the hands and feet (paraesthesia) Loss of vibration sense and proprioception Ataxia and difficulty with balance or coordination Cognitive impairment, including memory problems and difficulty concentrating Mood disturbances, including depression and irritability In patients with diabetes, distinguishing between diabetic neuropathy and B12 deficiency-related neuropathy can be challenging, as both conditions may coexist

The sludge-water-mixture from the aeration tanks is continuously fed into the clarifier, while supernatant water is discharged and return-sludge is recycled

Multi-dose vials and bacteriostatic preservative: Bacteriostatic water is supplied in multi-use vials (typically 30 mL)

A stock solution of isotopically labeled [ 15 N 13 ]-CNCbl (10 g/mL) was prepared separately in water

While they are stable at room temperature for shipping, long-term storage in a controlled, refrigerated environment is the best way to preserve their integrity before use

Promotes Healthy Coat: Enriched with essential nutrients that contribute to a shiny, lustrous coat in pets