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Individuals with Certain Medications : Long-term use of certain medications, including proton pump inhibitors (PPIs) for acid reflux and metformin for diabetes, can reduce Vitamin B12 absorption

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In summary, the reasons a GP surgery may refuse an early B12 injection are often rooted in a strict interpretation of established, but imperfect, guidelines, a misunderstanding of the actual science of B12 storage and metabolism, and a desire to maintain administrative consistency