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[56] [57] Low levels of serum vitamin B 12 may be caused by other factors than B 12 deficiency, such as folate deficiency, pregnancy, oral contraceptive use, haptocorrin deficiency, and myeloma

While we accounted for a significant number of relevant confounding variables, there is still the possibility of unmeasured confounders that might impact our results, such as dietary habits, including food history and stress levels

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WADA issued a formal clarification in response to public confusion about its status in 2013