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Diagnostic workup should rule out folate deficiency and include intrinsic factor antibody testing when appropriate

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The tools with the strongest evidence for anxiety and mood support include consistent sleep (seven-plus hours, regular schedule), regular physical activity (both resistance training and cardiovascular exercise have demonstrated antidepressant and anxiolytic effects), therapy or coaching for cognitive and behavioral patterns, mindfulness or stress-management practices, and social connection

Sterile needles prevent contamination during vial access procedures