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Elevated serum Hcy is another metabolite indicator of B 12 deficiency but is less specific than MMA, and there are not well established diagnostic cutoffs

[10] It is worth being exact about what that source says, because the naive reading goes too far in the other direction: the recommendation is to adjust the parenteral copper dose according to serum concentrations and the clinical picture, explicitly not to stop it, since discontinuing copper in cholestatic patients risks producing copper deficiency instead

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Lv et al., 2019)

Additionally, grass-fed beef is a healthier protein source since it is leaner