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For these people, vitamin B12 injections at a private GP clinic might be the answer

Causes of Falsely Elevated Serum Homocysteine and Methylmalonic Acid Levels Pernicious anemia should be suspected in patients without an obvious cause of malabsorption or who have a coexisting autoimmune disorder, such as vitiligo or thyroiditis

Bulletin of experimental biology and medicine , 135 (6), 590592

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