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Since there is not enough intrinsic factor for vitamin B12 to bind with and it cannot travel to the distal ileum to absorb into the blood, the body cannot absorb vitamin B12 properly

Rosanoff, A., Weaver, C.M

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Another source of endogenous electrophiles is the process of lipid peroxidation and oxidation of DNA bases

The guidance for neurological symptoms, recommending every-other-day injections, further highlights that the standard maintenance dose is not universally sufficient