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Clinical Manifestations of Vitamin B12 Deficiency Although the classic hematologic expression of vitamin B 12 deficiency is a megaloblastic macrocytic anemia characterized by an elevated mean corpuscular volume and mean corpuscular hemoglobin, and a peripheral smear containing macroovalocytes and hypersegmented neutrophils, up to 28 percent of affected patients may have a normal hemoglobin level, and up to 17 percent may have a normal mean corpuscular volume

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All protocols include structured follow-up to monitor joint function improvements and adjust therapy as needed

The main goal was to determine whether the ultra-high dose Rozebalamin could significantly slow disease progression on the ALSFRS-R after 16 weeks, or about four months

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