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It is generally contraindicated for pregnant or nursing women, and patients with active malignancies should consult their oncologist before starting any peptide therapy

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The serum B12 test alone misses many deficient patients, as high levels of methylmalonic acid and homocysteine have been identified as better indicators of B12 deficiency than the actual serum B12 level

Treatment typically involves vitamin B12 supplementation, either through oral supplements or injections, depending on the severity of the deficiency and underlying causes.

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