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Interaction with metformin or berberine (both AMPK activators) appears synergistic rather than competitive

Vitamin B12 is key to nerve health and making red blood cells
In the small intestine, detached from the R binder protein, the free B 12 binds to intrinsic factor from the stomachs parietal cells, allowing for absorption in the terminal ileum [33]

doi: 10.1016/s0008-6363(99)00094-2

Main P, Angley MT, O'Doherty CE, Thomas P, Fenech M