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Coeliac disease, inflammatory bowel disease (Crohn's disease or ulcerative colitis), and chronic pancreatitis can all cause both B12 malabsorption and diarrhoea
They can be
[5] Disruption of these pathways leads to accumulation of homocysteine and methylmalonic acid, metabolic signatures linked to megaloblastic anemia and demyelinating neuropathy
Subcutaneous injections are also highly effective and can be a gentler option for maintenance, offering a slow and steady release
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