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Constipation in B12 deficiency is primarily neurogenic, due to autonomic and enteric neuropathy causing slow gut motility • Constipation may precede anemia • Often improves after B12 replacement • Think of B12 https://dailymed.nlm.nih.gov/dailymed/image.cfm?name=00351662139424+Cyanocobalamin+pouch+label.jpg&id=767915 mthfr support B12-10000:100 Ml M., Shayoub, M

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