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"Patients will suffer from the usual side-effects of extreme tiredness, irrational behaviour, mood swings, memory problems." The British National Formulary, which sets guidelines for the use of vitamin B12 in pernicious anaemia, said the practice was based on the best available evidence base

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Haemoglobin below 100 g/L: Defer surgery

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UK clinical practice emphasises the importance of maintaining a high index of suspicion, particularly as neurological symptoms may precede haematological abnormalities