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Clinical Manifestations of Vitamin B12 Deficiency Although the classic hematologic expression of vitamin B 12 deficiency is a megaloblastic macrocytic anemia characterized by an elevated mean corpuscular volume and mean corpuscular hemoglobin, and a peripheral smear containing macroovalocytes and hypersegmented neutrophils, up to 28 percent of affected patients may have a normal hemoglobin level, and up to 17 percent may have a normal mean corpuscular volume

Enhanced Oral Bioavailability Thanks to the arginate modification, PDA resists degradation in stomach acid making oral dosing potentially viable and more consistent

That storage is one reason people with a deficiency sometimes feel the benefit for a longer window than someone using shots for simple upkeep

They act through signaling pathways

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