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If youre not taking supplements, your clinician may look for other explanations before recommending any change

The dosage depends on the total body weight

The variable and often vague presentation, combined with the limitations of laboratory testing, often create a diagnostic challenge

It was not until a genetically engineered strain of Pseudomonas denitrificans was used, in which eight of the genes involved in the biosynthesis of the vitamin had been overexpressed, that the complete sequence of methylation and other steps could be determined, thus fully establishing all the intermediates in the pathway