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Differentiating from Other Conditions Neurological signs and symptoms can be vitamin B12 deficiency associated or due to other causes such as: Pernicious anemia Syphilis Neurosyphilis Human immunodeficiency virus (HIV)-associated vacuolar myelopathy Toxic neuropathies Tropical myeloneuropathy Your healthcare provider can make a proper diagnosis based on your symptoms, medical history, physical exam, and laboratory test findings

However, topical applications are effective for maintenance, prevention, and mild concerns with the advantage of convenience and minimal side effects