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We appreciate the recommendation to consider an update factor more specific to diagnostic radiopharmaceuticals, which we will consider for future rulemaking

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Risk increases significantly after 2+ years of use Post-bariatric surgery patients gastric bypass removes or bypasses the sites of intrinsic factor production and B12 absorption People with autoimmune conditions pernicious anemia (anti-intrinsic factor antibodies) and autoimmune gastritis directly block absorption People with GI conditions Crohns disease (especially ileal involvement), celiac disease, SIBO, and chronic H

Sen S, Mondal S, Zheng L, Salinger AJ, Fast W, Weerapana E, Thompson PR (2019) Development of a suicide inhibition-based protein labeling strategy for nicotinamide N -methyltransferase

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