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The Chief Naturopathic medical officer of the Canadian College of Naturopathic Medicine wrote in 2011 serum levels of B12 not classically deficient by current laboratory standards are associated with neuropsychiatric signs and symptoms and Most clinicians do not consider vitamin B12 important unless the serum level is deficient when indicated by laboratory reference ranges

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Those requiring supplementationsuch as vegans, individuals with pernicious anaemia, or those with malabsorption conditionsshould follow guidance from their GP or registered dietitian to ensure appropriate dosing