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In any case, the physician must do a complete diagnostic workup to track down the reason for elevated vitamin B12 levels

That means: Hypokalemia can develop or worsen which can lead to: Cardiac arrhythmias Muscle weakness QT prolongation In severe cases, sudden cardiovascular instability This is a classic board-style pearl that many clinicians forget because B12 feels benign. But in profoundly deficient patientsespecially those with severe megaloblastic anemiarepletion is metabolically active treatment

I know I know that really but sometimes it's so helpful to have someone else say it too