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First, direct pharmacological interactions where one compound changes how another works in the body

however, it is not FDA-approved for humans, and the World Anti-Doping Agency has banned its use due to its benefits potentially enhancing athlete performance

Additionally, vitamin B 12 deficiency can also occur as a result of other malabsorptive conditions (such as inflammatory bowel disease, or pancreatic insufficiency), after certain procedures (such as bariatric surgery, or ileal resection), restricted diets (such as veganism), or the use of certain medications (such as metformin or proton-pump inhibitors)

Pract Diab Int