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The vitamin B12 deficiency involved in pernicious anemia is not brought on by inadequate diet, but rather by a relatively rare condition that inhibits the absorption of vitamin B12 in the gut, per MedlinePlus Medical Encyclopedia

Taking on an empty stomach facilitates faster absorption, while taking with food may reduce mild gastrointestinal irritation

Cold water added to cold powder dissolves more slowly and may not indicate complete dissolution accurately

There will be some resistance Advise relative rest for about 10 days, and then stretching and flexor and extensor strengthening exercises can be started