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Two, people with genuine B12 deficiency are, after withdrawal, at risk of developing worse symptoms, which may even persist after resuming treatment

This is the reason why bariatric surgery patients who underwent gastric bypass surgery are more susceptible to developing a vitamin B12 deficiency

In this patient, megaloblastic anemia was diagnosed based on clinical and laboratory findings of severe vitamin B 12 deficiency, for which subtotal gastrectomy is a known predisposing factor