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The content is not intended to encourage application, diagnosis, or self-treatment of unlicensed individuals, and should not be used as a substitute for the clinical judgment of a qualified healthcare provider
After reviewing literature and conducting a two-round Delphi survey with 42 experts, a consensus emerged that emphasizes prioritizing clinical symptoms in diagnosis, with serum B12 as a screening marker supported by methylmalonic acid or homocysteine levels for additional confirmation
329,330 In degenerative joint diseases like OA, the metabolic balance of chondrocytes is disrupted, leading to the overproduction of degrading enzymes and inflammatory mediators, including iNOS, MMP-13, and ADAMTS5 (a disintegrin and metalloproteinase with thrombospondin motifs 5), which participate in cartilage degradation and inflammatory processes
Other symptoms related to Vitamin B-12 deficiency are weight loss, loss of hearing, anemia, loss of appetite
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