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Oncoimmunology 6 , e1294296 (2017)

Because of this, I recommend any patient who is symptomatic and has suboptimal levels of vitamin B12 (as defined above) consider a trial of sublingual B12

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But in terms of testing, if you have classic B12 deficiency symptoms, even if you have normal B12 levels in your blood, and even if your MMA and homocysteine levels are normal, a therapeutic trial of B12 supplementation should be considered