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Rather than measuring B12 directly, the MR used 8 genetic variants (SNPs) known to raise B12 levels as a proxy for lifelong B12 levels

Undetected vitamin B12 deficiency due to false normal assay ...ncbi.nlm.nih.gov articles PMC3827408 by E Scarpa 2013 Cited by 25 Although measurement of vitamin B12 levels is the gold standard for the diagnosis of B12 deficiency some reports do exist concerning difficulties in its assay