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Conditions like celiac disease, inflammatory bowel disease, gastric surgeries, or chronic use of certain medications can reduce absorption from food and pills. If you have ongoing digestive issues, your provider may recommend a combination of gutsupporting strategiessuch as probiotics, a balanced diet, or targeted therapiesalong with B12, often using injections to bypass the digestive tract altogether

Often when they appear, it is due to a simple failure in measurement