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Conclusion Whilst severe B12 deficiency has a clear clinical picture with characteristic haematological and/or neurological features, establishing mild or borderline deficiency can be problematic as serum levels are maintained at the expense of tissue concentrations, and therefore serum levels of B12 may be in the low normal or borderline range despite a deficiency

Bitton, A

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But in real-world marketing, the term often gets stretched to cover everything from legitimate prescription medicines to loosely regulated research products sold direct to consumers