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Extending these trials to clinical endpoints such as anemia, neuropathy, or cognitive change would provide more definitive information, but such studies would be considered unethical

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For example, depending on the assay, serum B12 cutoffs for deficiency for adults may range from 120 to 180pmol/L, with 148pmol/L based on 3‑SDs from the mean of an adult reference range, said to be the most common cutoff for frank deficiency (IOM, 2000