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When consumed in excess amounts, its flushed out of the body through urine

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For the BMJ authors, the clinical picture is the most important factor in determining whether someone has B12 deficiency

For individuals who have trouble absorbing vitamin B12 or getting enough of this nutrient in their diet, a synthetic form of the vitamin called cyanocobalamin helps to correct this imbalance, delivering B12 directly into circulation in the body via an injection