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The absorption process is significantly hindered in conditions such as pernicious anemia, Crohns disease, celiac disease, and following ileal surgical resection, all of which can impair B12 absorption and contribute to suboptimal supplementation outcomes

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Pregnancy and Lactation B12 Requirements Pregnant and nursing women need more B12 because of their babys needs

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As indicated by the below graphs, the majority of participants unknowingly had suboptimal levels, but are still considered healthy by conventional standards

Note the confluence of drugs working on the growth hormone axis in this Table and the one above