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It causes discomfort and affects patients quality of life
Recommended investigations include: Full blood count with blood film examination Serum vitamin B12 level Serum folate (to exclude combined deficiency) Intrinsic factor antibodies Thyroid function tests (autoimmune association) Consider MMA and homocysteine if diagnosis uncertain and available Neurological examination should be performed in all patients, assessing for peripheral neuropathy, proprioception loss, and signs of subacute combined degeneration of the spinal cord
Vegans and vegetarians are especially likely to be low on B12 because B12 is only naturally present in animal products and meat
Haematological parameters (such as haemoglobin and red blood cell indices) typically begin to normalise within one to two weeks
While research continues to evolve, understanding these biological mechanisms provides a clearer and more realistic perspective on how peptides interact with complex physiological processes.
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