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In some cases, lab work may be recommended to assess deficiencies and guide appropriate dosing

It is primarily produced in the pancreas in response to ingestion of food and in proportion to caloric load (191)

810 Despite evidence that food insecurity can continue to be a problem after arrival, 11 it is often assumed that B12 levels will improve after arrival in a country where animal-source foods such as meat, eggs and milk are more readily available, and intestinal parasites have been eliminated

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[32] [35] Deficiency symptoms in children include developmental delay, regression, irritability, involuntary movements and hypotonia