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For patients whose levels fall in the borderline or gray zone, a methylmalonic acid (MMA) test provides greater specificity MMA levels rise when B12 is functionally inadequate at the cellular level, even if serum B12 appears borderline normal

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Cell culture studies show stimulation of beta-3 adrenergic receptors in adipocytes, increasing fat oxidation while inhibiting lipogenesis through acetyl CoA carboxylase blockade