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Clinical assessment and full blood count showing macrocytic anaemia are also important, though neurological symptoms can occur without haematological changes

Increased level of homocysteine is also an independent risk factor for developing pain by inducing peripheral neuropathy [31]

When sleep quality declines, stress hormones such as cortisol may increase, which can make the body more sensitive to nausea or gastrointestinal discomfort

The plan also includes a free app for ongoing support and messaging with a healthcare professional

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