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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

Two months since last injection and no improvement in face its worse

10 mg vial (common for starting doses) This is often the first vial new users receive

Helpful rule: Choose wellness injections for speed and focus

[DOI] [PubMed] [Google Scholar] 214.Tenn C.C., Kapur S., Fletcher P.J

Any excess B12 is eliminated by the kidneys