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Symptomatic vitamin deficiency is more likely if the person is rendered achlorhydric (a complete absence of gastric acid secretion), which occurs more frequently with proton pump inhibitors than H 2 blockers

Risks and Safety Considerations Despite promising research, several important safety issues should be considered

The published preclinical work (Neelakantan et al., referenced via PMC5826726) reported clean safety at 20 mg/kg subcutaneous in mice over 11 days