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B12 must be attached to IF for it to be absorbed, as receptors on the enterocytes in the terminal ileum only recognize the B12-IF complex, in addition, intrinsic factor protects the vitamin from catabolism by intestinal bacteria
Nursing care: Use proper IM technique, rotate sites, educate patient on side effects and schedule
High doses of B12 injections can help fix these issues and stop further damage
A rat study reported 38.4% oral bioavailability, while human oral and subcutaneous exposure remain unknown
When in doubt touch base with your Doctor
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