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The latter two are often elevated with B12 deficiency (MMA is especially predictive) while emerging evidence suggests that holotranscobalamin better reflects your B12 status than serum levels, says Miller, since it measures how much of the nutrient is actually being delivered to the tissues of your body

If there are no or minimal tolerable side effects, you can either maintain the current dose for the next four weeks, or work with our medical team to see if an increased dose is appropriate for you

Constipation may remain a long-term issue for some manageable with adequate fibre, water, and movement

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