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They can occur if a new medication is introduced, if the dose of medication is increased, or possibly with any change to a treatment protocol
[10] Initial assessment involves: Detailed medical history, including dietary habits and gastrointestinal symptoms Medication review (certain drugs like metformin and proton pump inhibitors can affect B12 absorption) [20] [21] Family history of pernicious anaemia or autoimmune conditions Physical examination for signs of anaemia or neurological abnormalities Laboratory investigations typically include: Serum vitamin B12 level: The primary test, though interpretation can be complex
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