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a 2025 literature review identified limited clinical evidence, including a retrospective study of 12 patients with knee pain and a Phase I trial in healthy volunteers whose results were not submitted

Proton pump inhibitors and H2 receptor antagonists, commonly used for gastroesophageal reflux disease and peptic ulcer disease, may affect vitamin B12 status through multiple mechanisms

Symptoms like fatigue, tingling in hands and feet, and mood changes are non-specific and overlap with many other conditions