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High-Strength Tablets: Standard tablets can also work, but only if your digestive system is healthy enough to properly absorb the nutrient

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Severe deficiency cases may result in pernicious anemia, typified by the development of abnormally large red blood cells

Because cobalamin in normally absorbed from food through the gastrointestinal tract, chronic diseases that adversely affect the ability of the intestines to absorb nutrients (inflammatory bowel disease is an excellent example) can lead to cobalamin deficiency

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This typically improves as treatment continues and should be discussed with your healthcare professional if persistent