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Pernicious Anaemia Challenges Recently a clinician colleague (also a PA patient) mentioned that they had received the dreaded we need to retest you letter

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It is knowing which patient needs a GLP-1 and which one needs a workup, how to titrate through the nausea window without losing the patient, how to protect lean mass during rapid loss, how to screen for the contraindications that matter, and how to tell a patient honestly what an adjunct will and will not do for them