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Finding the right B12 intramuscular dose is key to treating these issues well

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When you eat, insulin levels rise to facilitate nutrient storage

A B12 shot is a quick intramuscular injection of vitamin B12 (cobalamin) that bypasses the stomach acid, liver metabolism, and intestinal absorption issues that limit oral B12 to roughly 1% bioavailability in most adults

[7] In addition, oral contraceptives have been noted to lower serum B levels, though this effect is usually clinically insignificant