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These tend to follow the same pattern as nausea, peaking during titration and decreasing over time
Although the exact mechanism is unknown, this rise in melanocyte activity has been shown to be stimulated by prostanoids, cytokines, chemokines, and other inflammatory mediators as well as reactive oxygen species that are released during the inflammatory process
However, this test alone has a wide range of what is considered normal and may fail to pick up all vitamin B12 deficiencies
