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Urinary or plasma methylmalonic acid (MMA), a substance produced in the body thats dependent on B12, is also helpful for detecting early stages of B12 deficiency

Specifically, B12 in animals is essential for carbohydrate, fat and protein metabolism, and the formation and regeneration of red blood cells, as well as the maintenance of the central nervous system

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Its mechanisms are complex, but they are often linked to its interaction with the nitric oxide (NO) system and its influence on growth factor expression, particularly VEGFR2