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If you have pernicious anemia, any kind of digestive condition, or you've had gastric surgery, your gut may not absorb B12 the way it should

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doi:10.1016/j.jcjd.2024.08.002 Bjerre Knudsen L, Madsen LW, Andersen S, Almholt K, de Boer AS, Drucker DJ, et al

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If your deficiency is caused by metformin, you should take vitamin B12 injections either subcutaneously or intramuscularly