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Lau and Sarkar found that at the physiological pH, GHK-Cu complexes can form binary and ternary structures which may involve the amino acid histidine and/or the copper binding region of the albumin molecule

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After reviewing literature and conducting a two-round Delphi survey with 42 experts, a consensus emerged that emphasizes prioritizing clinical symptoms in diagnosis, with serum B12 as a screening marker supported by methylmalonic acid or homocysteine levels for additional confirmation