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this effect may be due to interference with erythrocyte maturation

Vitamin B12 is anessential factor fornormal growth in the widest variety of species of animals, foruninterrupted haematopoiesis (synthesis of nucleic acid) and the maturation ofepithelial cells, especially of the intestinaltract

Fish tapeworm infestation

Concurrent iron-deficiency anemia and folic acid deficiency may result in a blunted or impeded response to cyanocobalamin therapy.1

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