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Structural Stability: The disulfide bond between Cysteine 7 and Cysteine 14 creates a rigid cyclic loop essential for receptor recognition

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Common clinical drivers include: Vitamin B12 deficiency Folate deficiency Chronic liver disease Alcohol use disorder Medications (e.g., methotrexate) Bone marrow disorders Chronic inflammatory disease Hypothyroidism Key ICD-10 principle: Cell size is a laboratory observation