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In very lean individuals you can actually use insulin syringes to reach the depth of the muscles if you push hard enough on the skin

These include- Aged over 75 Decreased stomach acid Frequent use of antacids Autoimmune conditions affecting the stomach High doses of folic acid Stomach surgery Prolonged use of metformin Adoption of a vegan or vegetarian diet Excessive alcohol consumption How Does Vitamin B12 Benefit Your Body

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[DOI] [PMC free article] [PubMed] [Google Scholar] 193.Arch JR, Ainsworth AT, Cawthorne MA, et al

Options include: Fortified foods : Nutritional yeast, plant-based milk alternatives, breakfast cereals, and meat substitutes fortified with B12 (check labels for content) Supplements : Daily supplements of 10 mcg or weekly doses of 2,000 mcg ensure adequate intake, as recommended by the British Dietetic Association The body absorbs approximately 50% of a 12 mcg dose but only about 1% of a 1,000 mcg dose through passive diffusion

Treatment recommendations are individualized and require medical evaluation