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In UK practice, monitoring is primarily based on clinical response rather than routine blood tests, as post-treatment serum B12 measurements can be misleadingly high and may not reflect tissue levels

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Vitamin b12 deficiency symptoms can include peripheral neuropathy (numbness and tingling in the hands and feet), problems with balance and coordination, memory loss, trouble concentrating, changes in mental status, and depression, among other symptoms

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Department of Health and Human Services, ods.od.nih.gov/factsheets/VitaminB6-HealthProfessional/

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