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Using metabolic markers of B12 status like methylmalonic acid and homocysteine to aid in the diagnosis of clinically manifested vitamin B12 deficiency has advantages, but also shortcomings [10,11], such as the high costs of measurements, the limited availability, and the impact of renal insufficiency on the concentrations

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10.1001/jama.295.6.676 80 PezziniA.GrassiM.Del ZottoE.ArchettiS.SpeziR.VerganiV.et al (2005)