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The MHRA recommends considering periodic B12 monitoring in patients on metformin who have risk factors for deficiency, and testing if symptoms develop

26 Biochemical abnormalities commonly seen in patients with ASD include impaired methylation, sulphation capacities and low glutathione (GSH) redox capacity, all of which can potentially respond to B12 supplementation

[7] [8] Intrinsic factor antibodies may be tested if pernicious anaemia is suspected

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