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Both groups reached a similar maximal workload at CPET (218.0 51.4 vs 222.2 67.4 W)

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Endogenous causes (medical conditions) When B12 is elevated without supplementation , it can indicate that the body is releasing stored B12 from damaged tissues, producing excess B12-binding proteins, or failing to clear B12 normally

When levels drop, that conversion slows, and so does your drive to move