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When you take a B12 pill, it has to travel through your digestive system

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Vitamin B12 can then be absorbed into the bloodstream via endocytosis in the distal ileum, or by passive diffusion in the absence of intrinsic factor.2 Pernicious anemia (an autoimmune disease) affects the gastric mucosa, leading to destruction of parietal cells and failure to produce intrinsic factor, resulting in vitamin B12 malabsorption and eventually deficiency