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Vitamin B12 also may be involved in maintaining sulfhydryl (SH) groups in the reduced form required by many SH-activated enzyme systems
Patients should be aware that heavy, chronic ethanol use may counteract the therapeutic effects of vitamin B12
[1] Because intrinsic-factor-dependent uptake in the distal ileum can be absent in conditions such as autoimmune gastritis, pancreatic insufficiency, or bariatric surgery, the intramuscular or subcutaneous route bypasses gastrointestinal barriers and reliably restores serum concentrations
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