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There are special dosing rules and emergency plans for serious cases

Ethics declarations Acknowledgements This work was undertaken as part of UK Biobank project application ref 56653 Pharmacogenomics to improve drug efficacy and safety

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The problem started in the last decade with the availability of highly efficient oral and injectable forms of B12

If you take these long term, it is worth checking your B12 status, and injections may be recommended if a deficiency is found

Vegans and vegetarians are naturally at higher risk since B12 comes mainly from animal products