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The individual may find a significant amount of time consumed by thinking about, obtaining, or recovering from alcohol use

A 2025 European Journal of Clinical Nutrition commentary on the NICE guideline argued that the diagnostic threshold and clinical awareness still need to be tightened further, especially around pernicious anaemia, which is still under-recognised in primary care

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However, these combination therapies have not shown a significant increase in overall survival compared to chemotherapy alone [35,36,37,38]