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4,5 Dietary insufficiency, pernicious anemia (i.e., an autoimmune process that reduces available intrinsic factor and subsequent absorption of vitamin B 12 1,2,6,7 ), and long-term use of metformin or acid-suppressing medications have been implicated in B 12 deficiency

Side effects: GLP-1 medications are frequently associated with nausea, constipation, gastroparesis, and, in some patients, significant muscle mass loss alongside fat loss