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The specific site for administration may vary depending on factors such as individual preference, body mass, age, and any underlying medical conditions

large doses might diminish the effectiveness of antidiabetic medications (like insulin, metformin, or sulfonylureas)

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A second possibility is an undiagnosed autoimmune component, where pernicious anaemia is contributing to the deficiency on top of the bariatric anatomy

Some studies use an insufficiency threshold, in addition to a deficiency threshold