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Roux-en-Y gastric bypass surgery (RYGB) but not sleeve gastric bypass surgery or gastric banding, increases the risk of vitamin B 12 deficiency and requires preventive post-operative treatment with either injected or high-dose oral supplementation

83,84 Several environmental chemicals have also been shown to inhibit GI bacterial growth or to induce dysbiosis in vitro and in vivo

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These you can really affect your hypoxia of your cellular tissue

Nontoxic proteasome inhibition activates a protective antioxidant defense response in endothelial cells

And how do vitamins really support nerve health