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Minimizing Methylmalonic Acid Levels A potential problem with the IOMs method for determining B12 requirements (see Institute of Medicines Recommendations above), is that a small percentage of people with neurological symptoms of B12 deficiency have normal blood parameters, including 13% of patients in one series of case studies (Lindenbaum, 1988)

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The confusion compounds when you factor in reconstitution calculations , cycle lengths, and body weight considerations