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When given by intramuscular injection, the dose bypasses the digestive tract and is absorbed reliably, which matters because dietary B12 absorption depends on stomach acid and a protein called intrinsic factor, both of which decline with age, medication and certain gut conditions

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However, repeated IA injections may result in temporary hyperglycemia, skin redness, fever, popular-like changes, local infections, skin atrophy, and periarticular calcification