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In general, the research so far shows the following: Mild to Moderate Knee Arthritis: 80% of patients report good results for 1-2 years

More specialised tests such as active B12 (holotranscobalamin) or methylmalonic acid may be available through specialist referral, though availability varies across the UK

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The liver also plays a role in the enterohepatic circulationa recycling process where B12 is secreted in bile and reabsorbed in the intestinewhich may be disrupted in advanced disease

doi: 10.3390/nu14132702