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(31), where higher L-carnitine concentrations in the medium inhibited -butyrobetaine hydroxylase activity but left -N-trimethyllysine hydroxylase activity unaffected

In contrast, the EFSA reports that a cut-off value of 750 nmol/l is used for the diagnosis of cobalamin deficiency for all ages (EFSA, 2015)

These inconsistencies are due to variability in testing procedures, lack of standardization, differences in patient populations, and issues with patient cooperation