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While the risk of severe adverse reactions from these byproducts is considered low in properly sealed medication, it is not zero

If needed, your provider may recommend lab testing through your primary care physician to explore underlying factors like thyroid function or insulin resistance

Mechanisms by which PPIs, H2RAs, and metformin affect serum total vitamin B-12 concentrations PPIs and H2RAs are 2 classes of drugs that are used to treat conditions associated with excess gastric acid production, including dyspepsia, peptic ulcer disease, gastroesophageal reflux disease, Barrett esophagus, and Zollinger-Ellison syndrome

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