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Vitamin B 12 deficiency can develop for the following reasons: Absence of intrinsic factor, also called pernicious anemia: Intrinsic factor is a protein secreted by cells of the stomach lining
Local injection near the ankle may optimize outcomes, but systemic administration remains effective for those uncomfortable with ankle-area injections
Establish baseline measurements before beginning treatment
Professionally inked tattoos are also easier to target, as are older tattoos
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