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Before we can inject, we must mix it with a liquid

Allow refrigerated materials to gradually reach room temperature before reconstitution to minimize condensation

Roll gently for 30-60 seconds

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Intrinsic factor is only made in the stomach and after a gastrectomy there is little to no more of it or gastric acid, and the active mechanism in the body where B12 is absorbed is either less available or not available at all depending on if the surgery was a total or a part of a gastrectomy