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2 Table 2 Clinical Manifestations of Vitamin B12 Deficiency Maternal vitamin B 12 deficiency during pregnancy or while breastfeeding may lead to neural tube defects, developmental delay, failure to thrive, hypotonia, ataxia, and anemia

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Measuring your BAC water carefully matters just as much as measuring the final dose

Technical debt is not an option in this business where regulations are constantly changing and updating

So you can see from the above the challenges for doctors to consider so many factors to get to the correct diagnosis

This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur