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Passive diffusion accounts for about 1% of total absorption, and this route of absorption is unaffected in patients with pernicious anemia ( There were studies in the 1950s and the1960s that showed that oral vitamin B12 could be absorbed by patients with pernicious anemia and could lead to resolution of the anemia ( The objective of our review is to inform clinicians on the effectiveness of oral vitamin B12 as adequate replacement in patients with pernicious anemia, as well as make recommendations on the dosing and frequency of clinical and laboratory monitoring