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Intramuscular B12 injections bypass the gastrointestinal tract entirely and are recommended for malabsorption conditions or persistent oral intolerance
When levels are low, these metabolites can recirculate, contributing to symptoms of oestrogen excess
Eur J Prev Cardiol 25:495502 Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, Mattheus M, Devins T, Johansen OE, Woerle HJ, Broedl UC, Inzucchi SE (2015) Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes