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10.1074/jbc.R113.458810

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Individuals at risk of vitamin B12 deficiency include older adults, people with gastrointestinal disorders, those who have had gastrointestinal surgeries, individuals on a strict vegan diet, individuals who take metformin for blood sugar control, and people taking proton pump inhibitors for chronic heartburn

Khanna, N., Raval, P., Patel, D., Prajapati, R., & Schoop, J

Of note, many of these cases exhibit CSF oligoclonal bands, Gd-enhancing lesions on MRI and clinical response to immunosuppressionall features very typical of MSindicating that secondary immune responses to a primary trigger can play a significant role in the final clinical phenotype