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Other medications that will deplete this vitamin include: Metformin Antibiotics Methotrexate Colchicine Anti-seizure medications Cholestyramine Corticosteroids Others at risk are: There are various other reasons someone may develop a B12 deficiency, including: People who consume caffeine daily Chronic Alcohol users People consuming processed food or junk food regularly Smokers and potentially vapers Women taking oral contraceptives or birth control pills What Medical Conditions Can Cause B12 Deficiency

59 Prospective studies on this topic have focused mainly on normalising serum B 12 concentrations and should be interpreted with caution since the specific goal of treatment in symptomatic B 12 deficiency is alleviating symptoms

Drug Discov Today 2015;20:122-128

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This is uncommon but might contribute to symptoms in some patients, particularly those taking certain medications like diuretics

The 1,260 mg maximum tested dose far exceeds typical user protocols, suggesting standard doses carry minimal acute risk