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Have alcohol use disorder: Too much alcohol can harm the digestive system and make it difficult to absorb vitamin B12

for example, isoniazid, cycloserine, penicillamine, and hydralazine each form complexes with B or otherwise interfere with B metabolism, potentially leading to deficiency and peripheral neuropathy

however, the support for that is weak

People who have undergone some sort of trauma to the intestines including a gastric bypass or intestinal surgery can be susceptible to vitamin B12 deficiencies since they may have less cells present to produce the protein to which the B12 can attach, resulting in a decreased ability to absorb B12 into the bloodstream

It has been shown to decrease homocysteine levels, which is associated with the development of dementia and Alzheimers disease