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[6] [13] Proton pump inhibitors (PPIs) and H2-receptor antagonists , used for acid reflux, reduce stomach acid production and may affect B12 release from food proteins

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At baseline and at weeks 8 and 12, a clinician should assess fasting insulin and HOMA-IR (the homeostasis model assessment of insulin resistance, a calculated index derived from fasting glucose and insulin), HbA1c, high-sensitivity C-reactive protein as an inflammatory marker, and body composition by DEXA scan or bioelectrical impedance

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