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Pflipsen MC, Oh RC, Saguil A, Seehusen DA, Seaquist D, Topolski R

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[55] If nervous system damage is present and blood testing is inconclusive, a lumbar puncture may be carried out to measure cerebrospinal fluid B 12 levels

It should also be noted that people who follow a diet low in animal protein or who have a specific medical condition are likely to derive greater theoretical benefits from such supplementation