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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

I had very severe spots on my face and had quite a lot on my scalp too, when I started taking oral methylcobalamin in high doses

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

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