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A deficiency can occur for several reasons, such as pernicious anemia (a condition where the body cannot absorb vitamin B12 from the diet), certain medical conditions (e.g., Crohn's disease, celiac disease), surgical removal of part of the stomach or intestine, or strict vegetarian/vegan diets if not adequately supplemented

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Your physician should guide cycling decisions based on your response patterns, metabolic markers, side effect profile, therapeutic goals, and cost considerations rather than arbitrary predetermined schedules