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It takes a long time for a dose of warfarin to really kick in and knock out those clotting factors - at least 48 hours to begin affecting the INR for each dose in most patients, and even then, youre probably not be seeing the full effect of that dose on the INR

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In cases where clinical suspicion remains high despite normal B12 levels, additional testing with methylmalonic acid (MMA) or homocysteine levels may be helpful, though availability is limited in the UK and results can be affected by renal function