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If the treatment is inadequate due to poor understanding of B12 metabolism, and symptoms return as a result, that's due to poor research/lack of adequate knowledge on how to treat B12 deficiency properly in PA

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Validation of pathways up-regulated in regions of severe emphysema In order to investigate whether the up-regulation of components of the B cell receptor signaling pathway is associated with a change in the quantity of B cells in lung tissue, we quantified the Vv of CD79A protein, a marker for B cells, in relation to Lm by immunohistochemistry (see Additional file 1 for methods)

Neurology 75 , 15601566 (2010)