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Based on these conflicted results, the association was speculated to be related to the clinical features of the population, stages of the disease, severity of copper excess, and types of detected specimens in these studies (Table 1)

Dose Response

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Importantly, functional B12 deficiency can sometimes coexist with high total B12 levels, especially in kidney disease, and may require additional testing with methylmalonic acid (MMA) or holotranscobalamin if deficiency is suspected clinically