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Although this finding requires further investigation with respect to the functional biomarkers Hcy and MMA, the finding opens the possibility of early identification of vitamin B 12 insufficiency or deficiency during the first trimester of pregnancy and adequate treatment

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Now, history and physical exam must be "medically appropriate" for the presenting problem

doi: 10.1021/acs.analchem.6b04727 96 DunnWBBroadhurstDBegleyPZelenaEFrancis-McIntyreSAndersonNet al