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This is understandable, as the field continues to prioritize data from double-blind, placebo-controlled, randomized, controlled trials (RCTs) as the benchmark for therapeutic adoption

People taking heartburn medication, such as proton pump inhibitors, are at a higher risk for B12 deficiency and may benefit from alternative therapies to control/eliminate the heartburn or have regular Nutrient IV therapies and/or Vitamin B12 injections Elderly Vegans Vegetarians People with tapeworms Alcoholics Excessive use of antibiotics Excessive use of anti-convulsant medication Daily consumption of Aspirin may increase the risk for vitamin B12 deficiency

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doi: 10.1016/S0891-5849(98)00266-4 33

Limited range of motion: Gout can cause stiffness and difficulty moving the affected joint