Low B-12 | Figure 1

Low B-12

A 32-year-old female who recently moved from India came for a routine physical exam. She had concerns about hair loss but was otherwise healthy. CBC revealed low hemoglobin of 11.5 g/dL, reticulocyte count was 1.1 Retic abs (0.04), folic acid 12.1 ng/mL; and low vitamin B-12 of 109 pg/mL and repeat levels of 128 pg/mL ten days later. A peripheral blood smear is still pending. Advise on the next steps.

Update 1

CBC reveals thrombocytosis with platelets of 445 and hemoglobin of 10.8 g/dL.

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