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The American Society for Metabolic and Bariatric Surgery recommends that patients who have had bariatric surgery take 1 mg of oral vitamin B 12 per day indefinitely

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All these risk factors have a common characteristic, they are associated with a continuous state of oxidative stress and inflammation, excessive production of free radicals (reactive oxygen and nitrogen species) and endothelial cell dysfunction leading to cardiovascular disease and respiratory failure

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[7] Long-term use has also been associated with liver damage