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The table below summarizes common medications that have been associated with reducing the levels of vitamin B12 as well as the proposed mechanism for this interaction.1-12 The order of listed medications is alphabetical and not reflective of severity or level of importance

That said, clinical evidence supporting specific dietary eliminations such as gluten or dairy for perioral dermatitis remains limited and mixed as of 2026

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These correlations have been cited in support of the concept of the leaky gut wherein inflammatory states increase paracellular permeability to endotoxins and bacteria

This particularly affects users with thicker skin or compromised barrier function that reduces penetration efficiency