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However, certain populations are at higher risk of deficiency: Adults over 50 (reduced absorption capacity) Individuals following vegan or strict vegetarian diets Those with gastrointestinal conditions such as Crohns disease or celiac disease Individuals taking long-term acid-reducing medications (PPIs, H blockers) When oral supplementation is insufficient or absorption is compromised, vitamin B12 shots deliver the nutrient directly into the bloodstream, bypassing the digestive system entirely

Deamidation or Isomerization Selected residues may change according to pH, temperature and time

Sarah Berg, MD, is a board-certified OB-GYN and certified menopause practitioner who spent over a decade in clinical practice caring for women across all stages of life

Shen et al