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Because oral B12 supplements face a hostile digestive tract where up to 90% of the nutrient is lost, our clinical-grade intramuscular injections bypass the gut entirely

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In addition, the presence of the pro-inflammatory mediators, TNF and IL-1, also impair gut barrier integrity by activation of cell death pathways, such as apoptosis, thereby promoting elevated intestinal permeability (Ruemmele et al

Different individuals would theoretically require different doses, and susceptibility to side effects would vary based on individual factors - data we simply don't have