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Imaging analyses, laboratory testing, and clinical evaluation are typically used in combination for the diagnostic process

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However, certain groups require particular attention: Vegans and strict vegetarians must obtain B12 through: Fortified foods (plant-based milk alternatives, breakfast cereals, nutritional yeast) Regular B12 supplementation (typically 1025 micrograms daily or 2000 micrograms weekly) The Vegan Society recommends that all vegans supplement B12, as plant-based sources are unreliable and insufficient

As it was previously mentioned the secondary outcome measures observed by the researchers included gastrocnemius muscle mass and foot flexion contractures