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Stopping the offending MTX likely led to the resolution of pancytopenia, as did the eventual addition of leucovorin, perhaps, but the vitamin B12 repletion may have improved matters as well

Treatment depends on the specific b12 overdose symptoms

Vitamins B1B12: Mnemonics, Deficiencies, and Exam Clues From beriberi to B12 deficiency, the B-complex vitamins are heavily tested on Step 1 and Step 2 CK