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Another aspect considered by a healthcare provider before prescribing an adequate vitamin B12 dosage is your present medical state and your nutritional intake

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They will review your medical history (or may be able to assess you for anemia and treat as clinically indicated ) , help you understand the risks and symptoms of vitamin B12 deficiency, and share advice for prevention

So if you took B12 and felt worse, and your blood B12 is elevated, and you have a constellation of symptoms across multiple systems that's three signals pointing toward MCAS as worth ruling out