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But risks exist: improper use (high doses, unregulated supplements) may cause nausea, serotonin syndrome (with certain drugs), or nerve damage

8 Where results are unclear, serum MMA and homocysteine levels (both of which accumulate with B12 deficiency as discussed above) can also be used to confirm a diagnosis, although homocysteine is not specific to B12 deficiency, as it may also be caused by deficiencies in other B vitamins