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On the other hand, there is a separate study in Sweden that has followed patients after vagotomy and pointed out no relation between vagotomy and PD risk (Liu et al., 2017)

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8 Where results are unclear, serum MMA and homocysteine levels (both of which accumulate with B12 deficiency as discussed above) can also be used to confirm a diagnosis, although homocysteine is not specific to B12 deficiency, as it may also be caused by deficiencies in other B vitamins