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Many people have trouble with nutrient absorption due to the presence of intestinal inflammation, poor gut health, or a deficiency of Intrinsic Factor – a glycoprotein produced in the stomach that is essential for B12 absorption, whether from an oral supplement or food providing B12 (mostly liver, red meat + clams)

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193 It is important to note that some evidence indicates repeated high doses of cyanocobalamin may be harmful in those with kidney disease