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A full blood count typically shows macrocytic anaemia (elevated mean cell volume) with reduced haemoglobin, though this isn't always present, particularly in early deficiency or when neurological symptoms predominate

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Growth hormone stimulates hepatic IGF-1 production by binding to growth hormone receptors on liver cells, triggering intracellular signaling through the JAK2/STAT5 pathway that upregulates IGF-1 gene expression

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