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It is still possible to have PA with a negative result in IFA or PCA test

[153] There is evidence that for elderly people, physicians often repeatedly prescribe and administer cyanocobalamin injections inappropriately, evidenced by the majority of subjects in one large study either having had normal serum concentrations or having not been tested before the injections

Second, Alpha interferon which is a type of interferon 1 can cause tolerance disruption of myelin sheath antigen (222)

If I Take Daily Vitamin B12 Supplement Are Vitamin B12 Injections Still Beneficial