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Description

Baseline labs (B12, folate, metabolic panel, kidney function) are recommended before starting

Some people cannot tolerate the side effects of supplements like nausea, constipation, and a metallic taste

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After reviewing literature and conducting a two-round Delphi survey with 42 experts, a consensus emerged that emphasizes prioritizing clinical symptoms in diagnosis, with serum B12 as a screening marker supported by methylmalonic acid or homocysteine levels for additional confirmation