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It typically presents as macrocytic megaloblastic anemia and neurological impairments, including sensory and motor disfunctions, predominantly in the lower extremities, ataxia, and in more advanced stages cognitive decline progressing to dementia, as well as psychiatric disturbances (Sanjay et al., 2022
Fertility goals, baseline health conditions, medications, and psychological state all impact whether any experimental treatment would be considered
However, for many with chronic illness this route is insufficient
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