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The NHS treatment pathway and the 2024 NICE guideline both assume B12 injections are given in a clinical setting against a confirmed deficiency, not self-sourced and self-administered
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25 Patients diagnosed with vitamin B 12 deficiency whose history and physical examination do not suggest an obvious dietary or malabsorptive etiology should be tested for pernicious anemia with anti-intrinsic factor antibodies (positive predictive value = 95%), particularly if other autoimmune disorders are present
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