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Thyroid patients should use methylcobalamin or adenosylcobalamin because hypothyroidism often impairs the methylation pathways needed to convert cyanocobalamin into its active form

However, some people may experience nausea or indigestion when taking vitamin B12 on an empty stomach

pre- and post-operative treatment, when requirements are increased as in fever, severe burns, increased metabolism, pregnancy, gastrointestinal disorders interfering with intake or absorption of vitamins, prolonged or wasting diseases, alcoholism and where other deficiencies exist

Water Soluble Vitamins, 301

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