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Dose needs to be escalated by 0.25 mg every four weeks till patient reaches the max dose of 2.4 mg OR patient cannot tolerate dose escalation due to side effects

William Castle demonstrated that gastric juice contained an "intrinsic factor" which when combined with meat ingestion resulted in absorption of the vitamin in this condition

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Interestingly, most of the Tshr Df/Df rats can live a normal life span without the L-T4 treatment (data not shown), which implied that their phenotypes are less severe than the null mutants