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Some of the proposed mechanisms for metformin-induced vitamin B12 deficiency include: Interference with calcium-dependent binding of the IF-vitamin B12 to the cubilin receptor on enterocytes at the ileum level

The three pathways work together

However, when both parents are MMA carriers, newborn screening results are not sufficient to rule out the condition in a newborn baby

Sensitivity or Allergies to B12 or Its Components: Some individuals may have an allergic reaction to the preservatives or additives in B12 injections, especially those with known sensitivities to certain medications or substances

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