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10.1016/j.fct.2021.112117 Food Chem Toxicol

For patients with confirmed pernicious anaemia or malabsorption disorders, injectable therapy remains the recommended first-line treatment according to NICE CKS guidance, as oral supplementationregardless of dosecannot reliably correct deficiency in these circumstances

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However, the lack of regulatory approval means comprehensive safety dataincluding potential effects on sexual functionhas not been systematically collected or evaluated