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Continued efforts resulted in an analog characterized by increased hydrophobicity, decreased hydrogen bonding potential coupled with increased metabolic stability bonding potential, and significantly increased metabolic stability [69,72]

Individuals who have had gastrointestinal surgery, such as weight loss surgery, may also have fewer cells through which to secrete stomach acid and intrinsic factor, inhibiting B12 absorption

Some patients may use both forms depending on their goals, but this should only be done with provider supervision

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