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For example, in the US NHANES 2011-2014 survey, non-hispanic black adults had higher B12 concentrations than non-hispanic white adults, even after controlling for age group and B12 supplement use (Mineva et al., 2019)

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Considering the variety of clinical symptoms, an HC diagnosis may be demanding, although a common initial presentation is a symptomless patient with mildly elevated liver enzymes [29]