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Third, local effects in the gut may not require systemic absorption at all

Some patients also notice a mild fever or warmth, especially after B12 or high-dose B-complex formulations

What Did the 2025 Meta-Analysis Find About B12 Delivery Methods

With age, your stomach cells become less efficient and secrete less hydrochloric acid, which means you absorb less B12

Critically, neurological damage from B12 deficiency can become permanent if left untreated , which is why prompt diagnosis and treatment are essential