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Verification with serum methylmalonic acid and/or serum homocysteine level may be necessary in asymptomatic patients with high-risk conditions, symptomatic patients with low-normal levels of vitamin B 12 (200 to 350 pg per mL), or symptomatic patients in whom vitamin B 12 deficiency is unlikely but must be excluded

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This reversible modification acts like a protective shield, preventing these proteins from undergoing irreversible oxidation and permanent destruction

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