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medlineplus.gov

[11] It is less preferred than hydroxocobalamin for treating vitamin B 12 deficiency because it has a slightly lower bioavailability

The Need for Flexibility and Patient Advocacy The Pernicious Anaemia Society: As you noted, the work of the Pernicious Anaemia Society is crucial in highlighting these issues

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While patients typically experience efficient weight loss, they might feel lethargic and fatigued while taking the medication because of GI side effects and reduced calorie intake