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Medications including metformin, proton pump inhibitors, and H2-receptor antagonists may reduce absorption of B12, potentially prolonging the time to clinical improvement

For those on regular supplementation schedules like bi-weekly or monthly shots these intervals help maintain a steady state, ensuring ongoing therapeutic efficacy without noticeable dips

Their effect on body composition in research is driven substantially through reduced energy intake and improved insulin dynamics, not through direct action on fat cells

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