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[1] [4] The primary mechanism by which metformin interferes with vitamin B12 absorption involves calcium-dependent membrane action in the terminal ileum, where vitamin B12 is absorbed

GLUT4, which is primarily located in striated muscle (skeletal and cardiac) and adipose tissue, plays a major role in regulating glucose uptake and overall energy balance

Let your doctor (and the lab) know if you have been taking multi-vitamins, B12 supplements, fortified food and drinks and you still have symptoms

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Mirror progress is still subtle

Presented for research literature review only Letterie GS et al