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Mack reviews relevant health factors to develop a customized approach that aligns with each patients specific situation

One study by Tufts University found that nearly 40% of American adults have a B12 deficiency, and some doctors believe the rate to be higher

Conditions like celiac or Crohn's disease can impair B12 absorption

Accordingly, it has issued new advice to check vitamin B12 serum levels in patients being treated with metformin who have symptoms suggestive of vitamin B12 deficiency.[] The proposed mechanisms to explain metformin-induced vitamin B12 deficiency among patients with T2DM include alterations in small bowel motility, which stimulates bacterial overgrowth and consequential vitamin B12 deficiency, competitive inhibition or inactivation of vitamin B12 absorption, alterations in IF levels, and interaction with the cubulin endocytic receptor