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Whilst injections bypass gut absorption, conditions like active Crohn's disease or coeliac disease may cause increased metabolic demands that could influence how quickly B12 is utilised

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Although food can be the source of vitamin b12, there are certain conditions that do not favor the cobalamin absorption or make it excretes out of the body in large amount

[2] [16] Dietary deficiency without neurological features: Initial loading doses followed by maintenance therapy, with consideration of oral supplementation in appropriate cases