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The immune system attacks intrinsic factor, the stomach protein needed to absorb B12

And the answer is both simple and nuanced

Some people might also notice mild diarrhea or a feeling of swelling in their body, but these are typically temporary

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[10] [4] Patients should contact their GP if they experience persistent or severe side effects, signs of allergic reaction (facial swelling, difficulty breathing, severe rash), or if symptoms of B12 deficiency (such as neurological symptoms, severe fatigue, or glossitis) do not improve after several weeks of supplementation