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Several laboratory tests should be performed prior to treatment with cyanocobalamin, including serum vitamin B12, folate, iron, hematocrit, and reticulocyte count
Food Sources of Vitamin B12 meats fish shellfish poultry milk and milk products eggs cereal (fortified) nutritional yeast (fortified) Vitamin B12 is found only in animal protein foods and fortified foods
Conversely, a few studies reported high levels of vitamin B12 in the blood of patients with a worse COVID-19 outcome 48,49 potentially due to cytolysis leading to the release of intracellular B12 into the plasma and disrupted B12 clearance by the liver, which is often affected in these patients 50
Heat plus an opened vial is the worst combination
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