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Accurate diagnosis requires a comprehensive evaluation by a healthcare professional

Sometimes, patients will come to the clinic reporting one or more of the symptoms described above

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SAM is critical for the conversion of NAcSer to Melatonin, thus, in functional vitamin B12 deficiency, the production of Melatonin is reduced

This finding suggests that methylmalonic acid and homocysteine levels can be early markers for tissue vitamin B 12 deficiency, even before hematologic manifestations occur