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Review for any drug-drug interactions (especially with valproic acid, phenobarbital, or phenytoin)

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Causes of Vitamin B12 Deficiency Low dietary intake People who avoid animal-based foods (such as vegans or vegetarians)

Warnings: Patients with early Leber's disease (hereditary optic nerve atrophy) may experience severe and rapid optic atrophy when treated with vitamin B12. Additionally, treating severe megaloblastic anemia with vitamin B12 can lead to fatal hypokalemia due to increased erythrocyte potassium requirements

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