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113 It is known that perturbations in the microbiome can influence the production and absorption of nutrients, especially B vitamins, and hence it is, therefore, possible, as discussed above, these effects of metformin on the gut flora may contribute to the observed effects on vitamin B 12 status, with other possible consequences yet to be identified

Matsen 3rd et al

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This balanced approach enables researchers to study the individual contributions of each component as well as their combined effects in laboratory systems

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