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This article outlines an approach to interpreting and working up a high serum B12 in adults by separating four possibilities: intake-related elevation, disease-associated hypercobalaminemia (an elevated blood B12 associated with an underlying condition), analytical interference, and functional deficiency
B vitamins, including B1 (thiamine), B2 (riboflavin), and B12, also lose potency relatively quickly, especially if exposed to unfavorable storage conditions
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Endocrine Society Clinical Practice Guideline: Pharmacological Management of Obesity
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