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the first lab may measure and report a value of 220 pmol/l, and a different lab may measure and report 380 pmol/l, again in the same blood sample (!) There is day-to-day variation of serum B12

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In addition to the conditions mentioned above, several risk factors increase the likelihood of B12 deficiency: Smoking Alcohol abuse Endocrine-related autoimmune disorders (such as diabetes or thyroid disorders) Gastrointestinal disorders like Crohns disease History of gastric bypass surgery or other stomach-altering surgeries Optimize Your Health