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Signs that warrant evaluation include: pain radiating down the arm or leg persistent numbness muscle weakness worsening symptoms over time Imaging and a physical examination help determine the underlying cause of the problem

Maintenance Therapy : For ongoing maintenance, a monthly injection of 1 mg (1000 g) is generally sufficient to maintain adequate vitamin B12 levels in most adults

A clinical trial from Australia measured MMSE scores in response to B12 supplements in 20 adults aged 82 to 85 with low B12 levels (about 150 pmol/l)

A 2012 review by Goldstein et al