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In the first and second stages, lab testing will show declining levels of vitamin B12 and holotranscobalamin (transporter of B12), while MMA and homocysteine levels will remain within or around the normal range
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If serum calcitonin is measured and found to be elevated, the patient should be further evaluated
If you are really low you may need to do an injection every week for for or five weeks before you notice changes
Audrit KJ, Delventhal L, Aydin O, Nassenstein C
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