Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team
Its a bit odd, I know, to posit that a disease that can produce explosive diarrhea can cause bloating, gas and constipation while healing occurs, but indeed, this is the case
Karamian BA et al
806 This distribution highlights the need for enhanced training and support for PCPs, who are often the first point of contact for individuals with cognitive concernsbut it also underscores the importance of access to specialist care, particularly geriatricians, because of the often complex, multifaceted needs related to the diagnosis and care of someone living with dementia as well as their caregivers
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