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In summary, expect gradual improvements rather than an immediate surge

Before manifesting classic symptoms like pernicious anemia, patients may experience a stage of inadequacy characterized by abnormal levels of biomarkers related to vitamin B12 deficiency, such as holotranscobalamin, methylmalonic acid, and homocysteine

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Altered tight junction and transporter protein levels, accumulation of -synuclein and increase in inflammatory processes lead to extravasation of blood molecules and vessel degeneration