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Neurologic complications are not always associated with megaloblastic anemia and are the only clinical symptom of vitamin B 12 deficiency in about 25% of cases (21)

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(1982) examined the contents of three multivitamin preparations and, after incubating them in water at 37C (body temperature) for 2 hours, found that 20% to 90% of the B12 had degraded to inactive analogs