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Despite the obvious consequences of the functional B2 deficiency in the metabolism of B12, the majority of authors do not seem cognizant of this (Obeid etal, 2015), and seem to believe that B12 deficiency only occurs due to low intake of the vitamin, rather than ineffective processing, and are unaware of the phenomenon of Paradoxical B12 deficiency

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Metformin , a diabetes drug, can decrease B12 absorption, causing deficiency with long use