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Approved medications and provider-guided programs have clearer clinical pathways, safety monitoring, and prescribing standards

Medications: Certain medications, such as proton pump inhibitors (PPIs) and metformin, can interfere with B12 absorption

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Human results are not established, and large human trials have not been completed, which is a critical limit to keep in mind

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This was illustrated in the therapy of the bleeding disorders (Stupnisek et al., 2012