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Patients with pernicious anemia This autoimmune condition destroys intrinsic factor, the protein required for B12 absorption in the small intestine
The effect is mechanical: tirzepatide slows gastric emptying by 4050%, which increases glutathiones residence time in the acidic stomach where the tripeptide structure degrades before reaching the alkaline small intestine where absorption occurs
It is also advised to avoid alcohol for better treatment, as consumption of alcohol decreases the absorption of vitamin B from the gastrointestinal tract
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