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As chyme enters the duodenum it is mixed with bile (which helps digest fat), pancreatic juices and enzymes, and intestinal enzymes

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In France, the Strasbourg-based CARE B12 research group recommends differing treatment regimens for pernicious anaemia and other causes of B12 deficiency ( In Australia, the Immigrant Health Service of the Royal Childrens Hospital of Melbourne recommends varying treatment regimens based on age of the patient ( g-1mg IM OH-Cbl (preferred) or CN-Cbl daily is recommended on alternate days for 12 weeks then 250 g weekly injections until clinically improved, before switching to oral replacement treatment

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For tirzepatide users, the diet plan should focus on calorie-dense protein sources to maintain nutrition despite reduced appetite