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This is a vitamin deficiency anemia that’s characterized by the production of larger than normal red blood cells [2]

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TCB II: 42–47kDa protein Essential protein in the delivery of vitamin B12 to cells and tissues The production site of TCB II is primarily hepatocytic, and secondarily endothelial, monocytic and intestinal Functions of vitamin B12: B12 acts as a cofactor for two key enzymatic reactions: Methionine Synthase (cytoplasm): Converts homocysteine → methionine Requires methylcobalamin Supports DNA synthesis via the folate cycle (regenerates tetrahydrofolate) Methylmalonyl-CoA Mutase (mitochondria): Converts methylmalonyl-CoA → succinyl-CoA Requires adenosylcobalamin Involved in fatty acid and amino acid metabolism Elevated vitamin B12 (hypervitaminemia B12) While vitamin B12 deficiency is commonly discussed, elevated serum B12 (hypercobalaminemia) is less common and often overlooked or misinterpreted