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Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team
This protocol approaches the upper bounds of documented use and should not be exceeded without specific medical supervision
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A high-fat/high-protein, atkins-type diet exacerbates (in Eng)
As the previous paragraph shows, glutathione supplementation can help prevent deficiency
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