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Factors such as initial B12 levels, underlying medical conditions, certain medications, advanced age, and injection frequency can affect the absorption and utilization of B12, possibly shortening the duration of action

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For instance, a normal CBC with increased ferritin and transferrin saturation is suggestive of hemochromatosis, microcytic anemia with increased ferritin and transferrin saturation is strongly suggestive of thalassemia whereas macrocytic anemia suggests that there is an underlying cause of anemia such as hemolysis or megaloblastic anemia