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Absorption problems Even with adequate intake, absorption can be reduced by: Certain gastrointestinal conditions affecting the stomach or small intestine Some medications Age-related reduction in stomach acid (which can affect absorption) Autoimmune gastritis (often historically referred to as pernicious anaemia) This is a well-recognised cause of B12 deficiency and may require ongoing management

Drug interactions with methyl-donor-sensitive medications are theoretical, not confirmed

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doi: 14

They also found acupoint methyl B12 shots with acupuncture to help against intractable facial paralysis