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Diet strategy Caloric deficit is mandatory

Ha SB, Smith AP, Howden R, Dietrich WM, Bugg S, OConnell MJ, Goldsbrough PB, Cobbett CS (June 1999)

If you are a vegetarian, include wheat germ, soybeans, fortified bread, cereals, and grains, or take a daily B12 supplement

Testing is widely available, 5,8 but expensive, and multiple conditions may falsely elevate serum homocysteine and methylmalonic acid levels (Table 3)
