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Rossetti R, Ferrari I

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It is often prescribed for individuals with pernicious anemia or other conditions that impair B absorption (for example, after gastric surgery or in certain digestive disorders)

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However, this low rate of serious events creates a false sense that all discomfort should be dismissed as "the drug working." Persistent constipation, worsening stomach pain, or escalating symptoms often get normalized as inevitable rather than reported, blurring the line between expected adjustment and situations requiring medical attention