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These agents can raise blood pressure and blood sugar, so can be a problem for those with uncontrolled hypertension or uncontrolled diabetes mellitus

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Incidentally, the healthy reference range is 191-663 pg/ml and correlates closely with oral cobalamin intake, which is why the vitamin B12 blood level alone is not an adequate parameter to diagnose a deficiency (Herrmann and Obeid, 2014)