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Important things to keep in mind include: Serum B12 levels should be normal for most people Methylmalonic acid (MMA) and homocysteine levels can show if B12 is really working, even if levels seem fine How symptoms change is also important When and How to Adjust Dosing Regimens Doctors might need to change the dose based on test results and how the patient is doing

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For patients with Hashimoto's disease who also have type 2 diabetes, medications like Ozempic may be considered as part of a treatment plan following NICE guidance (NG28)