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[10] [11] Intramuscular B12 injections (hydroxocobalamin or cyanocobalamin) bypass the digestive system, but UK product information (SmPCs) for hydroxocobalamin injections does list gastrointestinal disturbances, including diarrhoea, as possible adverse reactions, albeit rare

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Previous Gastric Surgery: Procedures like gastric bypass can reduce the stomach's ability to produce intrinsic factor and absorb B12

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