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However, groups switched from WD to LD (WD/LD-V, WD/LD-T) tended to show greater alpha diversity compared to the control groups (WD/WD-V and LD/LD-V), which was not surprising since these animals experienced the most diet transitions with variable nutrient resources during their lifetime

Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team

PMID 27726382

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