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18 Prevention Because of potential interactions from prolonged medication use, physicians should consider screening patients for vitamin B 12 deficiency if they have been taking proton pump inhibitors or H 2 blockers for more than 12 months, or metformin for more than four months
However, you will need to speak with your qualified healthcare professional about the best options for you, as homocysteine has many factors involved
Also, just to note, those with darker skin tones, need to really quite careful with things like salicylic peels as they can cause pigmentation
doi: 10.1093/annonc/mdz059 69
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