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The circadian phase, response to light, and clock gene expression have been shown to differ between older and younger adults [43], which might cause a different response to VitB12

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Monitoring and follow-up Monitor clinically and repeat tests as indicated by the underlying condition Ongoing monitoring of liver function, renal function, and FBC as clinically indicated Regular review in primary care or specialist clinics for underlying conditions Patient advice: Patients should understand that elevated B12 is a marker requiring investigation rather than a condition requiring direct treatment