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Some other prescription medications can directly cause a vitamin B12 deficiency

The efficacy profiles of concurrent chemoradiotherapy with intensity-modulated radiotherapy followed by durvalumab in patients with unresectable stage III nonsmall cell lung cancer: A multicenter retrospective cohort study

In rare cases, allergic reactions like difficulty breathing, swelling of the face or throat, or a fast heartbeat may occur

Diagnosis of cobalamin malabsorption usually involves bloodwork to measure serum cobalamin levels and may include genetic tests, especially for informed breeding decisions

He's also taken the herb echinacea in an attempt to prevent cold and flu, but acknowledges the evidence is a bit mixed