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In addition, the lack of fever and chills helped rule out infections, while the absence of gastrointestinal symptoms, such as rectal bleeding, suggested that an acute gastrointestinal hemorrhage was unlikely

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Only this bound form of B12 can be correctly transported to the tissue and body store and thus utilised by the body (7, 8)

However, it's not entirely clear whether high vitamin B12 blood levels cause PV or the PV disease process may result in high blood levels of vitamin B12