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For example, people who maintain a vegetarian or vegan diet, people with absorption disorders, and those taking prescription meds like Metformin, Proton Pump Inhibitors (PPIs), and H2 blockers like Pepcid are often at greater risk

(PubMed) van Wijngaarden JP, Doets EL, Szczecinska A, et al

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These pleiotropic effects partially explain the opioid-sparing benefits observed in enhanced recovery surgical protocols and have spurred investigations into continuous perioperative infusions