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Or as Miller puts it, Youve essentially made the person equivalent of having pernicious anemia. Thats because these surgeries can reduce the production of both intrinsic factor and stomach acid, which is necessary for digesting food

115 Sterols themselves are poorly absorbed from the diet, but because of their chemical similarity to cholesterol, are thought to compete with cholesterol for absorption in the intestines, which has the net effect of reducing LDL levels

Hims has since relied on another regulatory exception allowing compounded drugs to be individualized for specific patient needs as determined by a doctor

Tell them about heart rhythm history too

Since Vitamin B12 is water-soluble, the body typically absorbs what it needs and excretes the excess through urine, giving it a very low toxicity profile