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Some patients may respond better to surgery than medication, especially if they have struggled with severe obesity for years and also have metabolic complications

GPs can prescribe B12 injections following appropriate investigation, which should include: Full blood count to identify macrocytic anaemia Serum B12 and folate levels to confirm deficiency (using laboratory-specific reference ranges) Methylmalonic acid and/or homocysteine when B12 results are borderline Intrinsic factor antibodies if pernicious anaemia is suspected Additional tests depending on clinical presentation (e.g., thyroid function, coeliac serology) When both B12 and folate deficiency are present, B12 should be replaced before folate to avoid precipitating subacute combined degeneration of the spinal cord

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Diminishing returns kick in above 0.07 mg per site

HFF-1 cells maintained in a T-25 cell culture flask (Corning, United States) at 37C in a 5% (v/v) CO 2 atmosphere and harvested at 90% confluence using 0.12% trypsin-EDTA

Quick math for common doses at 2.5 mg/mL: 0.25 mg: 0.25 / 2.5 x 100 = 10 units 0.50 mg: 0.50 / 2.5 x 100 = 20 units 1.0 mg: 1.0 / 2.5 x 100 = 40 units 1.7 mg: 1.7 / 2.5 x 100 = 68 units 2.4 mg: 2.4 / 2.5 x 100 = 96 units If you reconstituted with 3.0 mL instead (1.67 mg/mL), the same doses become 15, 30, 60, 102, and 144 units respectively