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Another concept is to measure B12 bound to the plasma protein transcobalamin (holoTC, active B12) before and after administration of three high physiological doses of B12 for two days

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Other risk groups include older adults, pregnant women, people taking metformin or long-term acid-suppressing medications (PPIs, H2 blockers), those with conditions affecting the gastrointestinal tract (pernicious anaemia, Crohn's disease, coeliac disease), and individuals who have undergone gastric or ileal surgery