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Physicians should consider that vitamin B12 levels between 200 and 300 pg/mL (148 to 221 pmol/L) are considered borderline, suggesting a possible deficiency, and further testing with methylmalonic acid (MMA) and homocysteine may be necessary

At this concentration, the risk of coma, respiratory depression, and death increases sharply

Indeed, sometimes the body itself produces too much hormone as a result of pituitary abnormalities

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