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While oral substitutes have shown some effectiveness according to studies, their ability to match the efficacy of intramuscular vitamin B12 remains uncertain

People with Digestive or Autoimmune Conditions Conditions such as Crohns disease, celiac disease, ulcerative colitis, and other gastrointestinal disorders can significantly impair the bodys ability to absorb nutrients, including B12

Patients with existing diabetes or kidney disease can have more adverse effects like further reducing the kidney function

People with long-term absorption problems may require ongoing treatment

I was started on weekly vitamin B12 shots and after the first I felt great