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There are many reasons for constrained supply, including tight regulation due to its classification as a schedule II drug which the DEA defines as "drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence." In addition, labor shortages, supply chain issues and an increase in the number of people who have been prescribed the drug in recent years may have an effect on supply

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People with digestive conditions like pernicious anemia or Crohns disease often struggle to absorb sufficient amounts

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