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Rarely, and almost exclusively from injections rather than oral supplements

Keep the vial tightly sealed

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Signs your body is asking for it

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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