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However, published human data remain sparse, and there are currently no large randomized clinical trials demonstrating safety and effectiveness for any approved indication

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PLoS One 5:e11065

Conditions such as pernicious anaemia (an autoimmune condition affecting intrinsic factor production, which should be confirmed with intrinsic factor antibody testing), Crohn's disease, coeliac disease, and those who have undergone gastric surgery (including bariatric procedures) may have severely impaired B12 absorption

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