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Some of the common triggers are: Using anabolic steroids Certain medications like antidepressant or hormone treatments Weight gain or obesity Drinking alcohol or using recreational drugs Liver or kidney conditions Low testosterone levels Sometimes, ongoing skin concerns, like acne linked to hormones, can be a sign that hormones are not balanced

Brenner M, Hearing VJ

Usually, B12 is absorbed once it is attached to the protein intrinsic factor (IF), made by cells in the stomach

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However, a key limitation of most of these studies that reported no association is their small sample sizes and the lack of longitudinal sampling necessary to capture transient viral infections