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Common causes include liver disease (which releases stored B12), kidney disease (reducing B12 clearance), haematological malignancies, solid tumours, and excessive supplementation
The acetate form is the standard for researchers replicating existing literature
Gastrointestinal symptoms such as nausea or stomach discomfort are among the most commonly noted
In contrast, a study with a smaller sample size (90 patients) concluded that such an association existed [113]
Meta-analysis of clinical efficacy of sildenafil, a phosphodiesterase type-5 inhibitor on high altitude hypoxia and its complications