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Description
In healthy individuals, amylin:insulin molar ratio is approximately 1:100 [10]

Furthermore, B12 deficiency is associated with elevated homocysteine levels, which have been implicated in various inflammatory processes
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Mechanisms of Ageing and Development (2024) 7
Compounding pharmacies vary

As you can see most of the causes are a result of not being able to absorb B12 in the first place and not actually from intake itself