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That is the honest answer to the argument you will find in forum threads: the rule is conservative and administrative rather than empirical, and it is still the number to use, because the alternative is having no number at all

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Two other surrogate markers of B12 deficiency are elevated homocysteine and MCV, although several other nutrient deficiencies can cause these levels to be elevated, so be sure to work with your provider when interpreting any lab test results