Patients with pancreatic insufficiency may have reduced cobalamin absorption (because pancreatic enzymes normally assist with the displacement of salivary haptocorrin binding protein by intrinsic factor), although such patients rarely become cobalamin deficient
But ordering too early means overlapping vials with competing BUDs
The zero withdrawal rate in AOD-9604 trials suggests excellent practical tolerability that extends beyond merely counting adverse events to assessing their real impact on treatment continuation
References Heffernan MA, Jiang WJ, Thorburn AW, Ng FM
Oral administration of cobalamin is as effective as parenteral Advantages of oral supplementation are comfort, ease of administration, and cost
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