Tiredness, stress, ill-health, poor or limited diet will all reduce this absorption further. For some people, taking a vitamin B12 supplement is one of the easiest ways to maintain healthy levels
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For example, if your Hb is low, and your MCV is raised, and then put on B12, and the Hb rises and MCV falls, there's the answer
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Bean, DJ, Monroe J, Liang YM, Borberg E, Senussi Y, Swank Z, et al