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There is some evidence that the diabetes drug metformin (Glucophage) may reduce vitamin B12 absorption when used for several years

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There is a documented reduction in the efficacy of inhibitory pathways originating from the brainstem, particularly those mediated by norepinephrine and 5HT from the locus coeruleus and rostral ventromedial medulla

This happens when the copper ion oxidizes when exposed to air and light
