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High doses of B12 may worsen the disease and cause irreversible damage to the optic nerve
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Scenario 4: Elderly patient on multiple medications including metformin A 68-year-old with type 2 diabetes takes metformin, a proton pump inhibitor for reflux, and is starting semaglutide for additional glucose control and weight loss
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It may also occur if your diet is deficient in foods high in vitamin B12 or if you are using drugs that prevent the absorption of this vitamin
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