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Vitamin B12 absorption begins in the mouth but mainly occurs in the stomach and small intestine with the help of intrinsic factor, a protein that helps your body absorb B12. Weight loss surgery results in anatomical changes, such as a smaller stomach, reduced stomach acidity, and changes to the small intestine, that can lead to vitamin B12 malabsorption and decreased intrinsic factor secretion

For most patients with knee osteoarthritis, viscosupplementation is absolutely worth trying before considering surgery

However, people with absorption problems or severe deficiency often require supplements or injections for effective treatment

Some injections may be taken weekly, while others are recommended monthly