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The incidence of this behaviour is increasing ..This appears to be due to a cost saving exercise and largely happens without any prior consultation with individual patients to discuss their needs

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A post-RYGB patient with serum B12 below 100 pmol/L may need eight to twelve weeks of aggressive repletion, sometimes with intramuscular injections, before I am comfortable operating

Even moderate alcohol consumption can decrease vitamin B12 absorption by about 5-6% Symptoms of Vitamin B12 Deficiency Historical records suggest that Grigori Rasputin suffered from a vitamin B12 deficiency