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A patient with unexplained fatigue should be worked up, not injected masking a B12 deficiency of unclear cause, or an unexamined thyroid problem, with a monthly shot is a real clinical risk

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After ingestion, stomach acid separates B12 from food proteins, and then intrinsic factor produced in the stomach lining binds to B12 so it can be absorbed in the ileum (the final section of the small intestine)