Rana Al-Hrout/LinkedIn
Oct 24, 2026, 10:13
Rana Al-Hrout: Vitamin B12 Deficiency – Neurological Symptoms Without Anemia
Rana Al-Hrout, Clinical Pathology-Hematology Specialist at Ministry of Health – Jordan, shared a post on LinkedIn:
“Can Vitamin B12 deficiency cause neurological symptoms without anemia?
The answer is YES!
Vitamin B12 deficiency does not always present with anemia or macrocytosis. Neurological manifestations may develop even when hemoglobin levels and MCV are within the normal range.
Key clinical and laboratory pearls:
- Neurological symptoms may precede hematological abnormalities.
- A normal CBC and peripheral blood film do not exclude vitamin B12 deficiency.
- Serum vitamin B12 levels should be interpreted in the clinical context.
- Methylmalonic acid (MMA) can help identify functional B12 deficiency, particularly when serum B12 results are borderline.
Clinical reminder: Do not rely on the CBC alone when vitamin B12 deficiency is suspected. Early recognition and appropriate replacement are essential to prevent potentially irreversible neurological complications.”
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