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In order to absorb B12 in the terminal ileum, the stomachs parietal cells produce a glycoprotein referred to as Intrinsic Factor (IF)

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This can happen because of past surgeries that changed the intestinal shape like gastric bypass and bowel resections, diverticula or small pouches in the intestine and intestinal kinking or narrowing from chronic inflammation or scar tissue

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A syringe can draw from any vial at any concentration with no cartridge loading required