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To increase specificity, the serum B 12 cutoff has been conservatively adjusted to our laboratorys lower reference range cutoff (160 pg/mL), and the serum MMA cutoff has been increased to 0.80 mol/L

In cases presenting with a severe B vitamin deficiency, Methylcobalamin injections are highly recommended

While pyridoxine (vitamin B6) is typically considered helpful in reducing vomiting and nausea, the American Academy of Family Physicians (AAFP) mentions that cyanocobalamin (vitamin B12) also significantly reduced vomiting episodes in pregnant women compared with placebo, indicating its role in nausea and vomiting management

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