If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at eight six one nine six six nine nine zero six. Alternatively, you can connect with me through the Practo app for a detailed consultation

Your reading of your own reports is correct. A B12 of 180-200 pg/mL for three years is borderline-low, and the picture behind it is already visible in your CBC - high-normal MCV of 100.9, MCH 33.5, raised RDW 14.8 and low RBC count. That is early macrocytosis from B12 deficiency, and a normal haemoglobin does not rule it out; anaemia is the last thing to appear, not the first. Being a lifelong vegetarian explains it, so yes, supplement - I would start methylcobalamin 1500 mcg daily orally for 3 months, then a maintenance dose long term, since dietary correction alone will not fix a vegetarian diet. Before starting, get serum homocysteine (and vitamin B12 repeat plus folate); a high homocysteine confirms true tissue deficiency and also matters for your heart risk. If levels stay flat despite oral therapy, we look for malabsorption or pernicious anaemia with anti-parietal cell antibodies and give injections instead. Also worth noting - you are on isotretinoin 20 mg, so your lipids and LFT should be monitored alongside. Book a consult with me on Practo with these reports and I will set the exact dose and follow-up schedule for you.

1.inj nomethvit eod intra muscular × 4 days day after one day 2.syp fab d3 nano  shot  60k once a day for 4 days then once a week 4 week 3.Tab ethicox p 1 tab morning--- half tab night 4.tab pregaba nt half tab hs all for 7 days

Tab mecodenz 5 one daily for 6 weeks. Take more of fortified cereals,  milk, cheese, paneer, curds, eggs, fortified soya milk, tofu, fortified almond milk.

Diet Take Neurokind M tablets 1 daily for 2 months and check b12 level and CBC after that

Eat b12 rich food ,eat more green vegetables and fruits Take T neurobion forte once daily for 8 weeks after food

Vegetarians often get low vitamin B12 because plant foods do not make this nutrient.You can fix low B12 levels by eating dairy, eggs, fortified foods, or by taking a safe B12 vitamin pill. Vegetarian Foods with Vitamin B12:- Milk, curd, and paneer Regular dairy items are easy ways to get B12. Eggs: One whole egg gives a small boost of B12. Fortified cereals: Look at boxes in the shop to find breakfast oats with added B12. Nutritional yeast: This yellow powder has a cheese taste and often has added B12. Fixing a Low LevelTake a pill: If your blood test shows low B12, food alone may not fix it fast. Watch caffeine: Do not drink tea or coffee right after your meals because it can block vitamin use.

If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at nine one one nine two five five six nine nine.

Need to take your drug history, and further evaluation for consistent low b12levels , take consultation

Requires a proper assessment to understand the underlying cause and guide you. Please book a consultation for a detailed evaluation, personalized treatment plan and further advice.

Tab neurokind od one at night for 2 months. For b12.

Yes,you need supplements, because vegetarian diet is poor source of b12 .only milk has some amount of b12 in veg. Diet .so better if you take supplements.

A B12 level around 200 for three years with a rising MCV and RDW does point toward ongoing deficiency, even with hemoglobin still normal. Being vegetarian makes this common.

Need a few more details please consult for further evaluation and treatment

Need few more details for further evaluation. Please consult

Avoid fried and spicy food Water intake more Green leafy vegetables more Fiber meal Walk Do connect and consult Will help u

Can help you, kindly consult and provide detailed history for proper diagnosis and further management