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[3] Sublingual and nasal preparations are available but are not routinely recommended within UK clinical guidance and may not be licensed as medicines

Medications can also influence B12 metabolism

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These injections, usually containing hydroxocobalamin or cyanocobalamin, are administered intramuscularly, thus bypassing the digestive system where the absorption problem occurs

RYGB alters the gastrointestinal tract, bypassing the duodenum and jejunum, reducing nutrient absorption and metabolism [5,6]

B12 shots are particularly beneficial for individuals with difficulty absorbing B12 from food or supplements