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and once on treatment they are told to keep patients TSH 'within lab range' (which is usually under 4/5 ish depending on lab) nice.org.uk/guidance/ng145/

Key distinguishing features, such as a low reticulocyte production index (RPI), hypersegmented neutrophils in cases of B12 and folate deficiencies, dysplastic changes in MDS, and macrocytosis linked to liver dysfunction in alcoholism, can aid in differentiating these causes [9]