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further notes that B12 injectables should be made available over the counter at pharmacies, which would bring our approach in line with that of other countries, affording those with B12 deficiency the same dignity and control over their own health as a diabetic using insulin, and reducing the workload and financial burden on GP practices, District Nurses and other NHS services

Environmental exposure also plays a role

Typically this type of decision would be made by those same career staff members

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The patient must be in good health with no active infections