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[7] In addition, oral contraceptives have been noted to lower serum B levels, though this effect is usually clinically insignificant

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That said, sublingual supplementation and intramuscular injections both bypass gastric absorption and may have higher efficacy rates

Injections are advised to circumvent potential absorption challenges in the gastrointestinal tract, particularly for those with known issues like Crohn's disease or irritable bowel syndrome, providing a more immediate replenishment compared to oral supplements, which may not be fully absorbed