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Deficiencies can lead to a host of issues, including pernicious anemia, depression, and cognitive decline

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However, for those without a deficiency, such high doses are unnecessary and should be avoided without a doctor's recommendation

At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population

Some notice that they look pale, though this is easier for others to spot than for the patient themselves