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B12 deficiency is more common with age, hypochlorhydria, small intestinal bacterial overgrowth, gastrointestinal bypass surgery, alcohol use, following a vegetarian or vegan diet, and use of medications such as proton-pump inhibitors, metformin, and hormonal contraceptives

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Figure 1 The mesocorticolimbic system, extended amygdala and glutamatergic neurotransmission The primary glutamatergic projections, associated with addiction include the mesocorticolimbic dopamine system and the extended amygdala as well brain regions mediating learning and memory (Figure 1)

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