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The Mayo Clinic lists the following medications as reducing B12 absorption: Aminosalicylic acid (Paser), Colchicine (Colcrys, Mitigare, Gloperba), Metformin (Glumetza, Fortamet, others), and proton pump inhibitors

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The Framingham Offspring study found that 39% of the general population may be in the low normal + deficient B12 blood level range

Breda PC, Wiech T, Meyer-Schwesinger C et al (2019) Renal proximal tubular epithelial cells exert immunomodulatory function by driving inflammatory CD4+ T cell responses