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Boyle CN, Lutz TA, Le Foll C

In the absence of gastric parietal cell or intrinsic factor antibodies, gastroenterology consultation and other diagnostic tests (eg, endoscopy) may be necessary to determine the cause of cobalamin deficiency if a clear and sufficient explanation is not readily evident from the patient's history (eg, a long history of adherence to a vegan diet, nitrous oxide exposure in surgery or recreationally, history of fish tapeworm infection, or a history of bariatric surgery, gastrectomy, or surgical resection of the terminal ileum)

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Your provider will review your results and discuss next steps during your visit