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Important things to keep in mind include: Serum B12 levels should be normal for most people Methylmalonic acid (MMA) and homocysteine levels can show if B12 is really working, even if levels seem fine How symptoms change is also important When and How to Adjust Dosing Regimens Doctors might need to change the dose based on test results and how the patient is doing

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This causes glycine , methylmalonic acid , and other harmful substances to build up in the blood and urine and cause health problems