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[6] Children in some regions of developing countries are at particular risk due to increased requirements during growth coupled with diets low in animal-sourced foods

Below is a comparison using available clinical evidence

Metformin (for diabetes), proton pump inhibitors (such as omeprazole or esomeprazole), and H2 blockers (such as famotidine) can all reduce B12 absorption over time

However, indirect factors such as reduced dietary intake from decreased appetite, altered gastric emptying, and concurrent use of metformin may increase the risk of B12 deficiency in some patients

Dan Wool, NMD Dr