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Thats why we recommend B12 injections only when there is a medically diagnosed deficiency or an absorption issue that prevents you from getting enough B12 through your diet

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[18] Vitamin B 12 deficiency may accompany certain eating disorders or restrictive diets

Although I had answers for all the scenarios this lead gave it ended up a stressful long telephone call

Additionally, there was variability between the included studies in the follow-up duration, which may cause heterogeneity in the results obtained