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22,23 In patients with a normal or low-normal serum vitamin B 12 level, complete blood count results demonstrating macrocytosis, or suspected clinical manifestations, a serum methylmalonic acid level is an appropriate next step 1,2,6,18 and is a more direct measure of vitamin B 12 's physiologic activity

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Reconstitution Protocol Add bacteriostatic water slowly down the interior wall of the peptide vial, do not squirt directly onto the lyophilised powder as this can denature the peptide

It ensures accurate diagnosis and documentation of skin anesthesia