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The severity and duration of deficiency are primary determinantspatients with mild, recently developed deficiency typically respond more rapidly than those with longstanding, severe depletion

There is no gold standard in testing for vitamin B12 deficiency

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Severe gastrointestinal disease or gastroparesis

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b12deficiency.info/ B12 books I found useful "What You Need to Know About Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper Martyn Hooper is the chair of PAS (Pernicious Anaemia Society)