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In cases of unexplained macrocytic anemia associated with high homocysteine levels and normal B 12 testing results, folate testing may be arranged if supported by laboratory specialist consultation

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Individuals with reduced intrinsic factor production (which increases with age), those taking metformin or proton pump inhibitors, and those with gastrointestinal conditions frequently absorb oral B12 poorly

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The guidelines recommend 21 days, known as a cycle, between each IV infusion