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Lifestyle Counseling: Nutrition: Recommends a moderate-calorie, balanced diet focusing on whole grains, lean protein, and vegetables

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It is not off-limits, but portions should be small and always accompanied by vegetables

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[51] Diagnosis [edit] According to one review: "At present, no 'gold standard' test exists for the diagnosis of vitamin B 12 deficiency and as a consequence the diagnosis requires consideration of both the clinical state of the patient and the results of investigations." [52] The vitamin deficiency is typically suspected when a routine complete blood count shows anemia with an elevated mean corpuscular volume (MCV)