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Used or opened pens cannot be returned, for sterility and chain-of-custody reasons consistent with research-chemical handling

Absorption problems Even with adequate intake, absorption can be reduced by: Certain gastrointestinal conditions affecting the stomach or small intestine Some medications Age-related reduction in stomach acid (which can affect absorption) Autoimmune gastritis (often historically referred to as pernicious anaemia) This is a well-recognised cause of B12 deficiency and may require ongoing management

The rules for IV push, infusions, and hydrations are more complex, however

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But that doesnt mean every formula is a safe bet