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While the definitive diagnosis typically rests with the pediatric hepatologist, the onus of early suspicion and timely referral lies with the primary care provider

This suggests that diabetes not only affects metabolic health but may also have significant negative impacts on the male reproductive system

Kulisevsky, L

Furthermore, they only look at serum B12 as a biomarker of B12 deficiency and do not consider methylmalonic acid, homocysteine, methionine, haematological parameters, or clinical symptomatology in their assessment of therapeutic effect