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Characterized by excessive fat accumulation in the liver, NAFLD can progress to more severe conditions, including nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and even liver cancer

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Where clinical suspicion remains high despite a normal serum B12, additional markers may be requested, including: Holotranscobalamin (active B12) a more specific marker of B12 status, available in some UK laboratories as an alternative or confirmatory test [11] [12] Methylmalonic acid (MMA) elevated in functional B12 deficiency