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History [edit] Descriptions of deficiency effects [edit] Between 1849 and 1887, Thomas Addison described a case of pernicious anemia, William Osler and William Gardner first described a case of neuropathy, Hayem described large red cells in the peripheral blood in this condition, which he called "giant blood corpuscles" (now called macrocytes), Paul Ehrlich identified megaloblasts in the bone marrow, and Ludwig Lichtheim described a case of myelopathy
However, important limitations remain
Hematocrit, reticulocyte count, vitamin B 12 , folate, and iron levels should be obtained prior to treatment
This distinction matters not because B12 injections are inherently dangerous, but because the systems surrounding the injection determine how quickly and effectively a provider can respond if something unexpected occurs
It affects many bodily functions
