NHS approach to B12 deficiency: NICE Clinical Knowledge Summaries recommend investigating B12 deficiency in patients presenting with macrocytic anaemia, unexplained neurological symptoms, or risk factors including pernicious anaemia, gastrectomy, malabsorption disorders, metformin use, proton pump inhibitors, or nitrous oxide exposure
The test then shows extremely high values beyond 1000 pg/ml of B12, although in reality there could well be an extreme vitamin B12 deficiency present (27-29)
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