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A complete medical history assessing for gut inflammation, celiac disease, GERD, recent nitric oxide use in surgery, and genetic factors like MTHFR should trigger a closer look at B12 adequacy even with a normal homocysteine (HCY) plasma test

Vitamin B12 is essential for red blood cell formation, DNA synthesis, and maintaining the myelin sheath that insulates nerve fibers

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A single course of phenobarbital for alcohol withdrawal (10-20 mg/kg cumulative dose within a short period of time) is unlikely to cause substantial enzyme induction