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This is also common in people taking medications like Proton Pump Inhibitors (PPIs) or metformin , which can block the absorption of B12 and other B vitamins

Inhibition of human dimethylarginine dimethylaminohydrolase-1 by S-nitroso-L-homocysteine and hydrogen peroxide

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Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine
