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Conversely, if a patient presents with “pernicious anemia” or severe neurological signs—such as intense tingling in the hands, memory loss, or muscle weakness—the dosage remains the same (usually 1,000 mcg), but the frequency increases significantly
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Examples of these health conditions include those with a lack of stomach acid, those who have undergone bariatric surgery, anemia caused by the inability to absorb the vitamin, other autoimmune digestive diseases, as well as several medications