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Oral B12 supplements face absorption barriers in the digestive system and may not effectively address severe deficiency

But for women with a BMI over 30, weight-related comorbidities (hypertension, type 2 diabetes, sleep apnea), or psychological impacts of significant weight gain, the clinical need may be substantial

Appeals succeed most often when denial reasons are specifically addressed with additional documentation, peer-reviewed research, or letters of medical necessity from specialists

But injections require more commitment