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For a drug administered orally, bioavailability may be less than 100% for two main reasonsincomplete extent of absorption across the gut wall and first-pass elimination by the liver (see below)

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Even people who get their B12 from animal-based products can still have difficulty absorbing B12

Some may require more frequent doses initially, especially when correcting a deficiency, before moving to a maintenance routine

thus, targeting NPY neurons/Y receptors specifically for obesity is not easy and could result in unacceptable side effects