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Persistent or progressive elevation of liver enzymes, particularly if accompanied by elevated bilirubin or decreased albumin, warrants prompt evaluation for alternative causes or medication-related hepatotoxicity

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20% of the over 60s are deficient in B12, and 11% of those who follow a vegan diet are also deficient The most common cause of Vitamin B12 deficiency is pernicious anaemia, however, it is estimated that 20% of the over 60s are deficient in B12, and 11% of those who follow a vegan diet are also deficient