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Thats because utilization of vitamin B12 (especially from supplements) depends on levels of other metabolic cofactors and acids

If the patient has an autoimmune disease or another condition that prevents the stomach from making intrinsic factor, then Vitamin B12 injections may be a better option

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Others schedule maintenance to help keep levels steady, especially if they follow a plant-forward diet, take certain medications that affect absorption, or have a history of deficiency