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It has to distinguished that the replacement therapy should be only undertaken to restore the physiological levels, never to exceed physiological ranges

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