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However, indirect factors such as reduced dietary intake from decreased appetite, altered gastric emptying, and concurrent use of metformin may increase the risk of B12 deficiency in some patients

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Cyanocobalamin (The Synthetic Form) Cyanocobalamin is a synthetic form of vitamin B12, not found in nature, and is commonly used in supplements due to its stability and low cost (OLeary & Samman, 2010)

It supplies purine and pyrimidine precursors for rapid tumor cell proliferation