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However, annual review with your GP is advisable to: Ensure adherence to the injection schedule Monitor for any new or worsening symptoms Consider testing for other autoimmune conditions if symptoms develop (particularly thyroid function, as thyroid disease is commonly associated with pernicious anaemia) [2] Gastric cancer risk: Pernicious anaemia is associated with a slightly increased risk of gastric cancer

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Some researchers attempt to salvage marginally exposed vials by immediately returning them to 28C and using them within 7 days rather than the standard 28-day window, but this creates uncertainty in downstream data