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Early warning signs include persistent fatigue that does not improve with rest, difficulty concentrating or brain fog, tingling or numbness in hands and feet, weakness in the legs, dizziness when standing up, pale or yellowish skin, and a sore or swollen tongue

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These include: Complete Blood Count (CBC) to check for better anemia Serum Vitamin B12 levels to make sure the dose is right Methylmalonic acid (MMA) and homocysteine levels to see how the body is reacting Reticulocyte count to see how the bone marrow is doing Clinical Improvement Markers We also watch for signs of improvement in how patients feel

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