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We describe a case of functional vitamin B12 deficiency where the repeated measurement of a serum B12 level within the normal range led to delay in the diagnosis of subacute combined degeneration of the spinal cord, and possibly permanent neurological damage as a result. Symptomatic patients may be suffering from B12 deficiency caused by parasites or infections such as SIBO, this can lead to misdiagnosis since serum B12 levels will often be within range despite a possible severe deficiency

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