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This situation can be confusing for patients

doi: 10.3389/fmicb.2014.00627 63 SerranoILuqueAAranJM

In pernicious anemia, holotranscobalamin decreases whereas in dietary deficiency, holotranscobalamin will remain relatively stable while total serum B12 decreases

Four supplements that I recommend taking, which generally produce a positive benefit and with very few side effects, are thiamine, magnesium, selenium, and zinc