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4,5 Dietary insufficiency, pernicious anemia (i.e., an autoimmune process that reduces available intrinsic factor and subsequent absorption of vitamin B 12 1,2,6,7 ), and long-term use of metformin or acid-suppressing medications have been implicated in B 12 deficiency

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It can also interfere with levodopa therapy if levodopa is taken without carbidopa, as vitamin B can diminish levodopas therapeutic effect

New therapeutic approaches that target cells and molecules believed to be part of the cause of lupus are being used to help many patients