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Conversely, if a patient presents with pernicious anemia or severe neurological signssuch as intense tingling in the hands, memory loss, or muscle weaknessthe dosage remains the same (usually 1,000 mcg), but the frequency increases significantly

Importantly, these effects occur without changes in food intake, indicating metabolic rather than anorectic mechanisms

This is because adequate exposure to stomach acid is needed to help the body absorb B12

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