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this leads to a malabsorption of the vitamin Certain medications use long term metformin use and chronic acid-reducing drugs decrease the absorption of vitamin B12 from food particles Malignancy of the pancreas or bowel Folic acid deficiency Semaglutide Semaglutide is contraindicated in patients with a history of angioedema, anaphylaxis, or other serious hypersensitivity reaction to semaglutide

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But you can get it from fortified plant milks, breakfast cereals, and other foods (check the labels to make sure B12 is included)