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37 Measuring serum concentrations of MMA and homocysteine may be helpful in establishing B 12 deficiency, especially in people with borderline serum B 12 levels, ie, those between 148 and 300 pmol/L

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Smoking Alcohol abuse Having endocrine-related autoimmune disorders (such as diabetes, or thyroid disorder) Gastrointestinal disorders such as Crohns disease Having undergone gastric bypass surgery or other surgeries that remove parts of the stomach