RT Journal
A1 Tilkian SM
T1 DEpendence on cyanocobalamin injections
JF JAMA
JO JAMA
YR 1989
FD September 15
VO 262
IS 11
SP 1468
OP 1469
DO 10.1001/jama.1989.03430110058016
UL http://dx.doi.org/10.1001/jama.1989.03430110058016
AB To the Editor. — 
    I started reading the article by Drs Lawhorne and Ringdahl1 with interest. By the time I finished, I was angry and depressed enough to write this letter. Throughout the article, there was no mention of how vitamin B12 deficiency can be scientifically assessed for clinical purposes.Current practice seems to emphasize the art of medicine, and also the economics of medicine under the guise of cost containment, at the expense of science. The workup of a patient with vitamin B12 problems can be expensive and inconclusive, but it can also be objective and scientific with minimum cost.2 One does not have to do Schilling or deoxyuridine suppression tests, measure vitamin B12 levels, perform gastrointestinal series, etc, which are expensive and sometimes uninformative. There are simple tests that every physician orders routinely but perhaps does not look at critically.For example, the