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Chronic myeloid leukemia, polycythemia vera, and hypereosinophilic syndrome are the classic associations, and the mechanism is thought to be overproduction of haptocorrin or transcobalamin by the expanded cell population

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Alternatively, introducing a refeed day or temporary caloric increase can reset metabolic adaptation and restore progress

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These associations were independent of demographic, socioeconomic, lifestyle factors, use of medications that could have an effect on serum vitamin B12 levels, dietary supplement use and fasting time