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18 Prevention Because of potential interactions from prolonged medication use, physicians should consider screening patients for vitamin B 12 deficiency if they have been taking proton pump inhibitors or H 2 blockers for more than 12 months, or metformin for more than four months

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And there’s a concern among many clinicians that, because BPC-157 seems to influence growth-related pathways, there’s a theoretical risk it could spur tumor growth if cancer cells are present