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Patients on Proton Pump Inhibitors or Metformin Long-term use of PPIs or metformin has been shown to impair B12 absorption
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Sublingual B12 bypasses intestinal absorption issues and potential barriers caused by genetic variants, which makes it a more accessible treatment option for vitamin B12 deficiency
[PubMed: 11564680] 137
Cyanocobalamin is contraindicated in those with hypersensitivity to cobalt moiety or cobalamin molecule due to the risk of anaphylaxis
