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The patient refused cobalamin injections to treat the anemia

For many individuals, oral B12 supplements are ineffective due to such underlying conditions as: Pernicious anemia : People with this condition lack intrinsic factor, a protein required for B12 absorption in the small intestine

Of course we cant know if this imposed reduced frequency had any impact however the word pernicious springs to mind

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If vitamin b12 levels arent maintained, you will eventually become deficient

More research is needed to determine whether vitamin B12 directly affects body weight or BMI