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It is important to check folate status alongside B12, but folate supplementation should not be started before excluding B12 deficiency, as this may precipitate neurological complications

Supplement Vitamin B12 For those with permanent B12 malabsorption, such as individuals with MTHFR gene mutations, vegans/vegetarians, IBD or ileum resection, Vitamin B12 supplementation is generally recommended

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Any elderly patient experiencing new or worsening neurological symptoms despite B12 treatment should be referred back to their GP for reassessment, as alternative diagnoses must be considered

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