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If subclinical vitamin B12 is suspected, then circulating total vitamin B12 or transcobalamin (TC)-bound B12 (i.e., holo TC) in serum should be measured first, followed by methylmalonic acid (MMA) or homocysteine in serum, both more sensitive functional biomarkers that reflect B12 stores rather than intake

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Stronger communication is critical, and health messaging must clearly state that these peptides are not linked to evidence-based science

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