The mechanism appears to be interference with erythropoiesis
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This can result in: Lipohypertrophy : Firm, rubbery lumps of fatty tissue that develop from repeated trauma and inflammation
High Blood Levels and Vitamin B12 Transport Molecules Another method that requires a visit to the doctor for a blood test is the holo TC test, which only measures vitamin B12 that is bound to the transport molecules, transcobalamin