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It is important to distinguish between excessive supplementation and pathologically elevated B12 levels, which may indicate underlying haematological disorders, liver disease, or renal impairment rather than true overdose
Worgall TS et al
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Also searched were the Agency for Healthcare Research and Quality evidence reports, Clinical Evidence, the Cochrane database, Essential Evidence, the Institute for Clinical Systems Improvement, the National Guideline Clearinghouse database, and the U.S
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