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The latter two are often elevated with B12 deficiency (MMA is especially predictive) while emerging evidence suggests that holotranscobalamin better reflects your B12 status than serum levels, says Miller, since it measures how much of the nutrient is actually being delivered to the tissues of your body

Saleh A, Smith DR, Balakrishnan S, Dunn L, Martens C, Tweed CW, et al

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