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Agreement on clinically relevant outcome measures is also lacking,71 and many studies have clear conflicts of interest

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A consultation with a Primary Care Provider is still a good idea if: Your B12 levels are persistently low or high without explanation You have a family history of autoimmune conditions or GI cancers You are vegan, over age 60, or on long-term medications that may interfere with B12 If symptoms persist, especially if they worsen, seeking medical attention is important to determine the cause and start appropriate treatment, says ter Keurs