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Metformin tops this list, with well-documented effects on b12 levels

Some B12 sources include: Plant-based B12 sources include: Fortified cereals Fortified nondairy milks Nutritional yeast Nori seaweed Tempeh Are There Side Effects

Moms who are strict vegetarians or vegans and are breastfeeding are at a higher risk for Vitamin B-12 deficiency

Potential interactions include: Metformin (used for type 2 diabetes) Proton pump inhibitors (PPIs) and H2-receptor antagonists (used for acid reflux) Colchicine (used for gout) Nitrous oxide (anaesthetic gas that can inactivate B12) Chloramphenicol (may reduce the haematological response to B12 therapy) If you take any of these medications long-term, discuss B12 monitoring with your healthcare provider