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People with Crohns disease, irritable bowel syndrome, gluten enteropathy (celiac disease), Pancreatic insufficiency, or any other disease that cause malabsorption of nutrients

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Without that, use is off-label and uncoupled from systematic safety monitoring

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If you do have decreased kidney function and your doctor recommends methylcobalamin, you may need a much higher dose because its less stable, so be sure to ask them about whats best given your condition