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Laboratory factors such as macro-B12 (immunoglobulin-bound B12) can cause spurious elevation on some assays

- People with significant liver disease (the 9-month monkey toxicology study showed dose-dependent periportal vacuolation in hepatocytes that the FDA flagged as a possible safety signal)

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Growth hormone, interferon-, and leukemia inhibitory factor utilize insulin receptor substrate-2 in intracellular signaling

B., & Periyasamy, L

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