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21 The Institute of Medicine recommends daily consumption of 2.4 mcg of vitamin B 12 in adults older than 18 years to prevent vitamin B 12 deficiency

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Regional medicines optimisation committee (RMOC) guidance suggests that decisions regarding biologic treatments, whether in treatment nave patients or in those using sequential therapies , should be based on shared-decision making to ensure treatment is appropriate, safe and clinically and cost effective[68]