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Some patients feel as though they want more frequent injections, and occasionally we test levels to see if they are receiving adequate replacement, but Im not sure how strong the evidence is to support this. GPs should consider periodic vitamin B12 testing of higher-risk patients who take metformin, even if they dont display symptoms of deficiency, the UK medicines regulator said earlier this year
Now, the difficulty with low B12 levels are that yes, they are more likely to be associated with intestinal problems, but we don't always get overt diarrhea or vomiting with those diseases
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