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Without enough copper, your body may struggle to utilize iron properly, even when your dietary iron intake is adequate

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Fogacci F et al

The same is true if your blood work only shows signs of mild abnormalities: high levels of reticulocytes (immature red blood cells), homocysteine (an amino acid broken down by vitamin B12), or methylmalonic acid (MMA, a byproduct of amino acid breakdown) should subside after just a few vitamin B12 injection treatments