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J Agric Food Chem

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discard if cloudiness or particles are present

Heart failure symptoms (rare, mostly in those with underlying heart disease): Shortness of breath Swelling in ankles or feet Rapid weight gain

For patients whose levels fall in the borderline or gray zone, a methylmalonic acid (MMA) test provides greater specificity MMA levels rise when B12 is functionally inadequate at the cellular level, even if serum B12 appears borderline normal