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This is reflected in the UK guidelines, which state that in the presence of discordance between the test results and strong clinical features of deficiency, treatment should not be delayed, to avoid neurological impairment. To us as chiropractors, missing a diagnosis of a functional B12 deficiency may mean the difference between a successful treatment for low back pain or a failure

American Journal of Physiology-Endocrinology and Metabolism, 291(6), E1290-E1294