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Pumpo R, Sarnelli G, Spinella A, Budillon G, Cuomo R (2001) The metabolism of nicotinamide in human liver cirrhosis: a study on N -methylnicotinamide and 2-pyridone-5-carboxamide production

They may recommend a blood test to confirm if you have a deficiency

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But if your B12 is high without supplementation , it can be a marker for underlying conditions that require medical evaluation, including liver disease, kidney dysfunction, and certain cancers

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