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Altered B12 handling and reduced clearance in kidney disease, and both cellular release and reduced clearance in liver disease, can raise B12, so supportive renal or hepatic findings make those causes plausible

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[7] Standard oral cyanocobalamin or hydroxocobalamin tablets can be taken with or without food

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For a more functional assessment, markers like methylmalonic acid (MMA) can be helpful, as they rise when B12 is functionally deficient even if serum levels are borderline