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A powerful case example was published in BMJ Case Reports: a patient diagnosed with primary progressive multiple sclerosis was being considered for ocrelizumab, but cervical spine MRI showed findings classic for cobalamin deficiency, including the inverted V sign. After parenteral cobalamin treatment, the patients neurological symptoms improved quickly and dramatically (BMJ Case Reports, 2019)

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The following minerals and their functions are deemed essential by the National Institute of Food and Agriculture Cooperative Extension

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