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people at higher risk of deficiency include older adults, those with gastrointestinal issues that impair absorption, people whove had gastric surgery, long-term strict vegans who do not supplement, and those on certain acid-reducing medicines
Research published on the hormonal axis has shown that growth hormone secretagogues can influence downstream steroidogenesis, which is why this category is frequently studied alongside testosterone-focused research rather than as a separate field
There is some evidence that the diabetes drug metformin (Glucophage) may reduce vitamin B12 absorption when used for several years
Athletes may be using these substances in the belief that they will give them an edge, although how common these illicit practices are is unknown, as they are shrouded in secrecy
