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Description

Deficiency causes megaloblastic anemia and subacute combined degeneration of the spinal cord

The chart above shows this accumulation pattern, with the sawtooth pattern representing the rise after each dose and decay between doses

Some GPs may incorrectly believe that only patients with a definite diagnosis of PA, those with a positive intrinsic factor antibody test, require treatment for life so seem to be using this as their treatment exclusion criteria