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Users exploring combinations like semaglutide and tirzepatide together or phentermine and tirzepatide together face similar evidence gaps
In a study of 10 healthy male volunteers, omeprazole, in doses of 20 mg-40 mg per day, caused a significant decrease in the oral absorption of methylcobalamin, vitamin B12

Protein drug stability: a formulation challenge

Along with alcohol as well as nicotine, long term antibiotic use could also reduce the stomachs ability to utilize and absorb vitamin B12
