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This is a firm rule, not a gray area

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While often temporary, this increase in platelets carries serious risks: Deep vein thrombosis (blood clots in deep veins, usually in legs) Pulmonary embolism (blood clots in lungs) Arterial thrombosis (clots in arteries) Cerebrovascular events (strokes) Coronary artery thrombosis (heart attacks) Splanchnic vein thrombosis (clots in abdominal veins) The risk is particularly high in: Elderly patients Those with pre-existing heart disease Patients with inherited blood-clotting disorders Immobilized individuals Those with hardened arteries Neurological Symptoms and Joint Pain Paradoxically, B12 replacement can temporarily worsen or trigger new neurological symptoms

doi: 10.1542/peds.2007-0640 143 KayaNAl-MuhsenSAl-SaudBAl-BakheetAColakDAl-GhonaiumAet al

Stomach acid reducers like Prilosec, as well as lansoprazole, pantoprazole, omeprazole, esomeprazole and raberprazole and others, put you at a higher risk of lowering your B12 levels