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Severe deficiency can contribute to fatty liver changes, which is one reason choline gets framed as liver support. Details are summarized in the NIH ODS Choline fact sheet for health professionals

Moreover, this condition leads to a low level of intrinsic factor, a protein that prevents vitamin B12 deficiency

These aren't subtle once you know what to look for, but they develop gradually enough that many people adapt without connecting them to a nutrient gap

If youre considering B12 shots as part of your health or weight management routine, consult your healthcare provider to determine if its the right option for you