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[9] Certain medications interfere with B12 absorption, most notably metformin (used for type 2 diabetes), proton pump inhibitors (PPIs), and H2-receptor antagonists when used long-term, as they reduce stomach acid production necessary for B12 release from food proteins

Phase 2 data showed up to 60% of participants at higher doses reported at least one gastrointestinal symptom

Hydration monitoring becomes more important during protocols that significantly reduce food intake, as a substantial portion of daily fluid intake typically comes from food

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