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When B12 levels are equivocal, additional testing with methylmalonic acid (MMA) and homocysteine levels can provide greater diagnostic accuracy, as both are elevated in true B12 deficiency
For the medicine, only side effects are described that have so far only occurred in exceptional cases
Patients taking multiple supplements should discuss potential interactions with their GP or pharmacist to ensure optimal nutrient balance
Patients considering combination approaches should understand that this represents an unproven strategy that increases cost and injection burden without documented benefit
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