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More specialized markers such as methylmalonic acid or homocysteine, which can clarify borderline cases, also take weeks to shift
If needed for a clear medical indication (such as treating pellagra in a pregnant patient), niacinamide can be used with caution, but unnecessary high-dose B supplementation is avoided in pregnancy
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It influences energy metabolism by improving glucose homeostasis and insulin sensitivity and enhances glucose uptake and utilization in cells which leads to improved energy metabolism
The doctor can prescribe multiple tests to determine the condition's underlying cause and severity
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