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doi:10.1038/s41467-018-04188-7 [PMC Full Text] [PubMed] [Crosslink] MacNee W

Lowest levels = worst symptoms Further analysis showed that the lowest levels occurred among participants whose symptoms were most severe, whose medical histories indicated they were resistant to previous treatments, or whose onset of the disorder occurred early in life

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50 The symptoms of subclinical B 12 deficiency are subtle and often not recognized

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