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When you swallow a B12 pill, several steps have to work for it to be absorbed: stomach acid and the enzyme pepsin must release B12 from food or the supplement, the stomach must secrete a protein called intrinsic factor that binds to B12, and the B12-intrinsic factor complex must reach the ileum (the end of the small intestine) where it is finally absorbed
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B12 injections are indicated for patients with documented deficiency, including those with pernicious anaemia, malabsorption disorders, following gastric surgery, or with neurological symptoms suggesting B12 deficiency
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