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For differentiation, 12 10 5 PBMCs were seeded in 1 ml complete medium containing 1 penicillinstreptomycin and 2050 ng ml 1 GM-CSF (PeproTech) per well in 24-well plates for 46 days, with medium changed every other day

Other factors that can cause vitamin B12 deficiency include gastrointestinal disorders, ageing, and certain medications like metformin and proton-pump inhibitors

PMID 40005999

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It is certainly not sufficient for a GP practice just to say that it is their policy or internal procedure