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At the same time, B12 insufficiency in the liver leads to shrinking of the intestinal cells and malabsorption of nutrients (including B12 itself), leading to a cycle of worsening B12 deficiency

Kosfeld et al., 2005

In summary, despite many studies indicating the oral administration of vitamin B12 to be easy, effective and less costly than intramuscular administration, their designs, and in some cases their methodological limitations, mean that debate still surrounds the effectiveness of the oral route

J Clin Diagn Res

As a retrospective analysis of electronic health records, it is susceptible to selection and ascertainment bias, and cardiovascular conditions and outcomes were identified primarily using ICD diagnostic codes, which may not always reflect specialist-confirmed diagnoses

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