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Importantly, these changes were observed without significant reductions in food consumption, pointing to enhanced energy metabolism rather than appetite suppression as the primary mechanism
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Conclusion Whilst severe B12 deficiency has a clear clinical picture with characteristic haematological and/or neurological features, establishing mild or borderline deficiency can be problematic as serum levels are maintained at the expense of tissue concentrations, and therefore serum levels of B12 may be in the low normal or borderline range despite a deficiency
In clinical practice, many cases of vitamin B12 deficiency are overlooked or sometimes even misdiagnosed
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