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When investigating elevated B12, additional tests such as active B12 (holotranscobalamin), methylmalonic acid, and homocysteine may help clarify true B12 status

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[6] If that occurs, it can sometimes be salvaged by allowing it to warm to room temperature

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At low or moderate doses, also called physiological doses, which are those we would get through food (although we could also include B12 provided by fortified foods or supplementation in very small amounts), absorption depends on the intrinsic factor secreted and the intestinal receptors of the Castle complex, which regulate absorption