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10.1016/j.neuroscience.2017.04.035 Neuroscience

Less commonly: anxiety, heart palpitations, insomnia

Drugs that decrease or reduce absorption of B12: antibiotics, cobalt irradiation, colchicine, colestipol, H2-blockers, metformin, nicotine, birth control pills, potassium chloride, proton pump inhibitors

Essentially, we don't want phase 1 to be too fast (and create excess acetaldehyde), but we do want phase 2 to work efficiently and as fast as possible (to effectively remove acetaldehyde)

Hepatic encephalopathy, as a consequence of advanced liver disease, is the major manifestation of the perturbed brain-gut microbiome axis