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Folic Acid, vitamin B9 is not a substitute for methylcobalamin, vitamin B12 deficiency, although it may improve vitamin B12 megaloblastic anemia
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A vegetarian diet which contains no animal products (including milk products or eggs) does not supply any vitamin B 12
Specific clinical scenarios where injections are the standard of care include pernicious anemia, severe malabsorption syndromes, post-bariatric surgery when oral supplementation has failed, and critically low serum B12 levels accompanied by neurological deterioration
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