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For individuals with conditions like pernicious anaemia, an autoimmune disorder that attacks the protein needed to absorb B12, oral supplements are often completely ineffective

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This rapid response makes injections particularly valuable for people experiencing acute deficiency symptoms

Experimental investigations have explored its effects in models involving body composition, metabolic health, and cellular energy balance

So yes, symptoms can get worse before they get better

Vegetarians and vegans are also at risk because B12 is mainly in animal products