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If the underlying physiology creates a persistent tendency toward weight gain, ongoing pharmaceutical support may be the most effective strategy, just as ongoing antihypertensive therapy is the most effective strategy for people with essential hypertension

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Vitamin B12 deficiency can also be found in people with poor nutrition, pernicious anemia, infection, cancer, surgery, alcohol, medications (PPIs or other acid-suppressing drugs), exposure to nitrous oxide (during surgery or recreational use), stomach/intestinal problems such as intestinal dysbiosis, leaky gut or gut inflammation, atrophic gastritis or hypochlorhydria (low stomach acid) and/or nerve damage