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Department of Health and Human Services, ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/

Typically, conventional treatment involves the administration of high-dose vitamin B12 injections

IM injections into skeletal muscle trigger localized inflammatory responses (elevated IL-6, TNF-alpha at the injection site) that can confound studies measuring systemic inflammation or immune modulation

Having an autoimmune disease : Some autoimmune diseases can damage the stomach lining (including pernicious anemia) where intrinsic factor is produced

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