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NHS approach to B12 deficiency: NICE Clinical Knowledge Summaries recommend investigating B12 deficiency in patients presenting with macrocytic anaemia, unexplained neurological symptoms, or risk factors including pernicious anaemia, gastrectomy, malabsorption disorders, metformin use, proton pump inhibitors, or nitrous oxide exposure

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Extending beyond this window without a washout period may lead to diminishing returns or disrupt endogenous methylation processes via SAMe depletion