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Reduce dose by 50% for 35 days, then re-escalate slowly

Consider coeliac disease screening if iron deficiency is present or symptoms suggest malabsorption

This distinction matters because many economic models assume sustained treatment over multiple years

Prior authorization typically requires 3-6 months of documented lifestyle modification attempts

Normally, vitamin B12 is released from food in the stomach, where it binds to a protein called the intrinsic factor, which is essential for its absorption in the small intestine

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