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We order vitamin B12 and folate testing when a person with Down syndrome we are evaluating has symptoms described above, has a lab abnormality for which follow up testing of vitamin B12 and/or folate is indicated, or the person has a condition in which deficiency is common (e.g., celiac disease)

If symptoms, lab concerns, or a known medical condition are driving the question, a clinician should help determine whether testing, primary care follow-up, or another next step is needed

Studies as early as 1998 validate the use of correct oral treatment as being equally effective as injections, with a conclusion that stated: In cobalamin deficiency, 2,000mcg of cyanocobalamin administered orally on a daily basis was as effective and may be superior for raising blood B12 levels as 1,000mcg administered intramuscularly on a monthly basis

Synergistic effects may enhance skin, hair, and overall anti-aging outcomes

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