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Medical conditions like gastroenterological disorders may hinder B12 absorption

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The most common form of anemia is due to a lack of iron, but inflammation (say, from RA) can also cause anemia as can blood disorders and cancers

[1] [3] The injection bypasses the gastrointestinal tract entirely, making it particularly effective for patients with absorption problems such as pernicious anaemia or those who have undergone gastric surgery

If you are diagnosed with anemia, you may be given a prescription of B12 shots