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For example, if you are being treated for type 2 diabetes with medications such as metformin, your ability to absorb vitamin B12 from the digestive tract may be reduced

S., Taieb, C., & Skayem, C

These effects are mediated by modulation of neurotransmitters (serotonergic, dopaminergic) and preservation of the blood-brain barrier

And some may be easily managed

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Importantly, folic acid should not be given alone before B12 deficiency is excluded or treated, as this can mask anaemia while allowing neurological damage to progress