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If the GP says that she doesn't have macrocytic anaemia so doesn't need this pattern of treatment, you could point out that NICE guidelines for B12 deficiency say that "Note: clinical features of vitamin B12 deficiency can occur without anaemia and without low serum levels of vitamin B12." cks.nice.org.uk/topics/anae

This is important because some absorption enhancers achieve their effects through mucosal damage, which is not acceptable for repeated administration

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non-operative therapy often poorly describe the treatment of the nonoperative group

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