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Laboratory studies may show evidence of massive hepatic necrosis with elevated AST, ALT, bilirubin, and prolonged coagulation times (in particular, elevated prothrombin time)

Therefore, although gastric bypass surgery is beneficial for weight loss, it also can cause vitamin B12 deficiency

Provider supervision, hydration, gradual dosing, proper nutrition, and safe injection technique may help reduce risks

Key Takeaways Residency training after medical school takes 3-7 years depending on specialty, with internal medicine requiring 3 years while neurosurgery demands 7 years plus optional fellowships

Proc Natl Acad Sci 97:48444849

doi: 10.1016/j.ccell.2022.02.003