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Global, regional, and national burden of multiple sclerosis 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016

Importantly, serum B12 levels can be misleadingly normal or even elevated in chronic liver disease due to increased levels of binding proteins (such as haptocorrin) and reduced clearance, meaning that total B12 measurements may not accurately reflect tissue B12 status or functional deficiency

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