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Because most of what the test measures is inert haptocorrin-bound B12, it is entirely possible to have a normal or even high total B12 while your cells are functionally short

The slow-aging growth hormone receptor/binding protein gene-disrupted (GHR-KO) mouse is protected from aging-resultant neuromusculoskeletal frailty

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Ortega-Vega EL, Guzmn-Castaeda SJ, Campo O, Velsquez-Meja EP, de la Cuesta-Zuluaga J, Bedoya G, et al