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This is one reason the middle third is safer than the upper third

Some oral contraceptives and anti-inflammatory medicines can deplete blood levels of all of the above, making this an especially wise choice for some women

The mechanism behind oral efficacy is attributed to systemic absorption and downstream peptide signaling rather than localized delivery, though the exact bioavailability percentage in humans remains unquantified

Quite often though, a patient with B12 deficiency experiences symptoms getting worse before better when treatment with B12 injections start -so it can take a while to feel improvements