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Baseline labs anchor the decision: bloodwork is ordered before any vial is opened, not after the patient is already cycling

Functional cobalamin deficiency in the general United States population (2024) What was found: researchers analyzing more than 22,000 adults from the National Health and Nutrition Examination Survey defined functional cobalamin deficiency as a raised methylmalonic acid despite a serum B12 above 400 pg/mL

Note - some medication vials contain only a single dose, while some contain enough medication for multiple doses

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