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Surgery Stomach surgery such as a gastrectomy which involves removing part of your stomach may increase your risk of developing vitamin B12 deficiency due to reduced absorption Crohn's disease This disease can lead to inflammation of the digestive tract and may reduce how much vitamin B12 your body absorbs What are the symptoms of vitamin B12 deficiency

That is one of the reasons, as the NICE guideline says, that we need to adjust treatment to the patients symptoms, not do a blood test or prescribe a one-size-fits-all dose

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