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43 Another possible underlying mechanism involves an autoimmune process in which immune cells become activated against the myelin proteins specific to the facial nerve

Deficiency after gastric banding is therefore primarily related to: Reduced dietary intake and food tolerance , limiting consumption of B12-rich foods Use of acid-suppressing medicines (PPIs or H2RAs) , which can impair the release of B12 from food proteins and reduce absorption of food-bound B12 Crystalline B12 the form found in supplements and fortified foods does not require acid or pepsin for release

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in total, 9 genera (including the unclassified group) and 38 metabolites met these criteria (metabolites published in Sampson et al., 2021 13 )