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It usually happens immediately after and in lesser cases, several hours post-vaccination

Are pregnant: Vitamin B12 levels tend to dip during pregnancy and return to normal after delivery

[1] Because intrinsic-factor-dependent uptake in the distal ileum can be absent in conditions such as autoimmune gastritis, pancreatic insufficiency, or bariatric surgery, the intramuscular or subcutaneous route bypasses gastrointestinal barriers and reliably restores serum concentrations

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Oral manifestations of vitamin B12 deficiency associated with pernicious anemia: a case report