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Methylmalonic acid (MMA) and homocysteine levels: Both become elevated in B12 deficiency and can help confirm diagnosis when serum B12 is borderline

This energy impairment likely results in a hypometabolic state as the illness progresses (59, 401, 407, 413), called the cell danger response (414416)

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Step 4: Ongoing Support and Monitoring Regular follow-ups ensure optimal results, address any questions, and adjust treatment as needed for best outcomes

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