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Long-term use of PPIs can lead to Vitamin B12 deficiency. PPIs cut down on stomach acid, which is needed to release Vitamin B12 from food proteins
The foundational mechanism papers from the Washington State University lab that described how Dihexa works were retracted in April 2025 following a misconduct finding, with a third paper under an Expression of Concern since 2021
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Clinical validation remains limited because large-scale human trials and regulatory approval are not established
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