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Use long-term medications that affect absorption Acid-reducing drugs, metformin, and certain antibiotics have been linked with lower B12 levels

Zeng Z, Liu W, Tsao T, Qiu Y, Samudio I, Baggerly K, Kornblau SM , Kantarjian HM, Andreeff M, Konopleva M

The only shared downstream effect is increased energy expenditure, but even that occurs through completely different mechanisms: Retatrutide through glucagon-driven thermogenesis, and Tesamorelin through growth hormone-mediated metabolic activity