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Injection therapy if needed For individuals with absorption problems, monthly or prescribed injections ensure steady levels regardless of gut health.[12]Vitamin D and K2 Combination for Bone Health — Integrative Medicine Insights View source High-dose oral supplements for absorbers Those who can absorb B12 normally can use daily high-dose oral supplements (500–1000 mcg) as an effective maintenance strategy

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Theories include alteration of bile acid metabolism, small intestinal bacterial overgrowth, effects on intestinal motility and interference by metformin on vitamin B12-intrinsic factor absorption in the terminal ileum