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Berg and Shaw presented a cascade-testing algorithm that stratified patients first by total serum vitamin B 12 levels and second by MMA levels, using cutoffs of 118 pmol/L and 0.80 mol/L, respectively (Berg and Shaw, 2013)

This is crucial for patients who cannot absorb B12 through normal dietary means

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By simultaneously targeting TGF- and these additional pathways, it may be possible to achieve a more comprehensive inhibition of the fibrotic process