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Your doctor may recommend earlier testing if you: Develop neurological symptoms Experience unexplained fatigue Have anemia Take high-dose metformin Have digestive disorders affecting absorption Have previously been diagnosed with vitamin B12 deficiency Rather than following a fixed calendar, clinicians usually individualize monitoring based on the patients overall health

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If the skin feels tight against bone (common directly over the kneecap), move 2-3 cm laterally until you can pinch a fold

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Elderly patients with cardiac conditions or those taking loop or thiazide diuretics may be particularly vulnerable