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[12] Gastric acid-suppressing agents (proton-pump inhibitors and H-receptor antagonists) diminish dietary B12 liberation from protein complexes, a pharmacodynamic interaction that can exacerbate underlying deficiency

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Functional/Acquired IGF-I Deficiency - Uncoupling of GHR Signaling to IGF1 Gene Transcription and Maintained GHR Metabolic Signaling Due to Insulin Deficiency Increased GHR signaling in obese children does not generally result in elevated IGF-I, due to negative feedback inhibition of GH