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There is a large indeterminate zone between normal and abnormal levels (see Figure1: B 12 Test Result Review and Process Algorithm for Patients with Risk Factor for B 12 Deficiency* and/or Non- Specific** or Specific Symptom of B 12 Deficiency below)

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CMAJ 2012;184:1593-8

If the total homocysteine is elevated, contact the laboratory pathologist to facilitate further investigations