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2021 Dec;48(6):219

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8 Where results are unclear, serum MMA and homocysteine levels (both of which accumulate with B12 deficiency as discussed above) can also be used to confirm a diagnosis, although homocysteine is not specific to B12 deficiency, as it may also be caused by deficiencies in other B vitamins

(2020) Comparison of sublingual and intramuscular administration of vitamin B12 for the treatment of vitamin B12 deficiency in children