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Many epidemiological investigations have reported an association between lower levels of vitamin B12 or folate (or elevated blood homocysteine and methylmalonic acid, which are metabolic indicators of vitamin B12 deficiency) and Alzheimer disease or other forms of cognitive impairment (57

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Early haematological response begins with reticulocytosis (increased production of immature red blood cells) typically by day 3-4 of treatment , particularly with injectable forms, though the full resolution of symptoms may take several weeks to months