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People with malabsorption or gastrointestinal disease Conditions such as pernicious anemia, post-gastric surgery states, celiac disease, long-term proton pump inhibitor use, or other malabsorption syndromes reduce absorption of B12 from food and pills

When there is an unreliable or inadequate oral absorption of vitamin B, it is better to use the injection route as a faster and more certain way to provide relief

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