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Vitamin B12 deficiency can be occurring while vitamin B12 levels are at levels not typically associated with deficiency due to the presence of deleterious MTHFR mutations. 5 If you have one or more MTHFR, MTRR or MTR gene mutations, you will be less able to methylate B12 or convert your B12 to methylcobalamin

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[1] [2] Blood levels of B12 may rise quickly following injection, though elevated blood levels do not immediately translate to symptom resolution