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Metformin has also been shown to inhibit the calcium-dependent absorption of the vitamin B12IF complex at the terminal ileum

A 25-hydroxyvitamin D test confirms a level of 15 ng/mL, indicating deficiency

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The 2024 NICE Guideline NG239 from the United Kingdoms National Institute for Health and Care Excellence similarly distinguishes between patients who can be managed with oral therapy and those who require intramuscular treatment

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