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However, if there are neurological symptoms that have arisen due to B12 deficiency, they could take up to three months to improve, with mild improvements occurring in the first six weeks

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Other indicators include a family history of pernicious anaemia or other autoimmune conditions (such as type 1 diabetes mellitus, Hashimotos thyroiditis, or Graves disease), or if the patient is taking metformin, proton pump inhibitors (PPIs), H2 antagonists or has a history of nitrous oxide misuse[15]