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The Working Group on Growth Hormone Insensitivity Syndromes

A general practitioner or neurologist can use a physical exam and blood or urine tests to measure the level of B12 in your system

Titration: There is generally no need for upward titration with B-complex vitamins as one might do with certain drugs, but if a patient is frail or known to react to injections, the provider may choose to start at a lower dose (for example 0.25-0.5 mL) and then increase to 1 mL as tolerated

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Therefore, the absence of gastric parietal cell antibodies doesnt exclude pernicious anemia
