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Because B12 in the blood is continuously removed, the concentration gradient remains relatively constant

The answer is not always simple

but Im also encouraged by anecdotal evidence from my own practice and that of my colleagues in addiction medicine

Primary systemic carnitine deficiency Primary systemic carnitine deficiency is a rare, autosomal recessive disorder caused by mutations (including deletions) in the SLC22A5 gene coding for carnitine transporter protein OCTN2 (organic cation transporter novel 2) (33)