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Approach Extended cycle Duration 6-8 weeks Review Point Week 6 Typical Context Less common

similarly not universally available and has multiple causes Full blood count to identify macrocytosis or megaloblastic changes Blood film to assess red blood cell morphology NICE CKS guidance and the British Society for Haematology (BSH) recommend that clinical symptoms should always be considered alongside laboratory values, particularly in high-risk groups such as post-bariatric surgery patients

This means it carries theoretical concerns around stimulating growth in tissues where growth is not desired

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