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It typically presents as macrocytic megaloblastic anemia and neurological impairments, including sensory and motor disfunctions, predominantly in the lower extremities, ataxia, and in more advanced stages cognitive decline progressing to dementia, as well as psychiatric disturbances ( Subclinical B12 deficiency, however, is far more prevalent, affecting up to 26% of the general population
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However, two other forms hydroxocobalamin and cyanocobalamin become biologically active after they are converted to methylcobalamin or 5-deoxy adenosylcobalamin, said Dr Aravinda G M, consultant, internal medicine, Manipal Hospital, Jayanagar, Bangalore
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