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B12 injections are also used to treat people with malabsorption (gastrointestinal conditions that prevent proper absorption of B12 from the gut), for example, people with atrophic gastritis (stomach inflammation) and intrinsic factor deficiency (pernicious anemia) or those who have undergone surgical procedures such as gastrectomy or small bowel resection (stomach or intestine removed), autoimmune diseases, etc

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High-dose biotin can distort assays that use a biotin and streptavidin step, so holding biotin supplements and re-testing can help when interference is suspected