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Metformin decreases IF, bile acid metabolism for ileal reabsorption, binding of vitamin B12 and IF in the small intestine, decreases cubulin-B12-IF complex binding to amnionless complex, and increases vitamin B12 accumulation in the liver.[2] PPIs decrease H secretion to form hydrochloric acid in the stomach

Lifelong exposure to a low-dose of the glyphosate-based herbicide RoundUp causes intestinal damage, gut dysbiosis, and behavioral changes in mice

Patients with neurological symptoms require urgent same-day treatment initiation to prevent irreversible nerve damage

The prescribing information includes warnings about acute kidney injury, particularly in patients experiencing volume depletion