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Intrinsic factor is only made in the stomach and after a gastrectomy there is little to no more of it or gastric acid, and the active mechanism in the body where B12 is absorbed is either less available or not available at all depending on if the surgery was a total or a part of a gastrectomy

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Form of B12: Many clinics use cyanocobalamin (a synthetic form of B12 which requires a number of conversions) for their B12 shots

So its easy to wonder how much is actually safe to take