How can a conclusive diagnosis of Vitamin B12 deficiency be made?

If MMA and homocysteine levels are increased, then an early or mild B12 deficiency may be present. This may indicate a decrease in available B12 at the tissue level. However, If only homocysteine levels are elevated, then folate concentrations should be checked. If MMA and homocysteine levels are normal, it is unlikely that there is a B12 deficiency.

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