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Women with histories of hormone-sensitive cancers (e.g., breast cancer) should be especially cautious

Using the correct anatomical site is precisely how trained clinicians avoid this

A retrospective study looking at concomitant use of proton pump inhibitors (PPIs) alongside metformin in 614 people with type 2 diabetes in the US found a significant reduction in B12 levels of 34% in patients taking both medications, compared to controls taking either drug alone (Long et al, 2012)

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