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NICE NG28 and the MHRA advise considering B12 monitoring in long-term metformin users who have symptoms or risk factors for deficiency, as metformin can impair B12 absorption in the terminal ileum

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It's an instinctive action for mixing things, but in this context, it's destructive

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Because the body is efficient at excreting excess B12 through urine, there is no established tolerable upper intake level (UL) for the vitamin

Document IENFD result (fibers/mm), skin biopsy site, and diagnosis statement to support specificity