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So people at greatest risk for deficiency include those with low stomach acid (e.g., older adults and people on proton pump inhibitors or antacids) or low IF production (known as pernicious anemia), people on medications that interfere with B12 absorption (such as metformin), people who have had gastric surgery, those with GI conditions that impair nutrient absorption (like celiac or Crohn's disease), and people on vegan and vegetarian diets

Also, B12 levels are not generally checked during routine blood work

Paul C, Cather J, Gooderham M, Poulin Y, Mrowietz U, Ferrandiz C,

When these enzymes detect alcohol, they break it apart so that your body can eliminate it