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In humans, hyperhomocysteine is related to cobalamin deficiency [52], whereas in dogs, homocysteine can be used mainly in the diagnosis of familiar cobalamin deficiency specifically in the Chinese Shar-Pei [53], but only after other diseases have been ruled out [54]

In some rare cases, very high levels of B12 in the blood can be associated with minor side effects like mild acne, dizziness, or a temporary rash

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