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B12 injections are medically indicated for individuals with a diagnosed B12 deficiency or conditions that impair B12 absorption, such as pernicious anemia, Crohns disease, celiac disease, or a history of gastric bypass surgery

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Minor, temporary flushing or mild fatigue as the body actively detoxifies can sometimes occur in the early days of enhanced antioxidant activity, but these are generally considered signs of the body normalizing its functions