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8 A case-control study that compared 25,956 patients who had vitamin B 12 deficiency with 184,199 control patients found a significantly increased risk of vitamin B 12 deficiency in patients who had taken proton pump inhibitors (odds ratio = 1.65) or histamine H 2 blockers (odds ratio = 1.25) for at least two years

N Z Med J 129 Kotilea K, Quennery S, Decros V, Hermans DA (2014) Successful sublingual cobalamin treatment in a child with short-bowel syndrome

Whats more, alcohol also prevents nutrients from being fully absorbed by your body and stimulates the growth of intestinal bacteria that use vitamin B12, thus reducing even further the available amounts of this essential vitamin