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The Mayo Clinic notes that people with pernicious anemia, gastrointestinal surgery, or certain malabsorption conditions often cannot absorb oral B12 effectively, making injections the preferred route for correcting clinically diagnosed deficiency

Alcohol can interfere with the normal absorption of B12 in the gut The body's ability to absorb B12 from food can be reduced because alcohol can damage the lining of the stomach and intestines

No lethal dose has been established in animal studies, even at dosages many orders of magnitude higher than those used in therapeutic research

The dosing and the duration shift with the operation