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Mind Your Medications and Supplements: In the days leading up to your visit, please avoid taking blood-thinning medications or supplements or certain herbal remediesunless otherwise directed by your healthcare provider

Autoimmunity: Certain autoimmune conditions can cause pernicious anemia

it works upstream, on an enzyme called nicotinamide N-methyltransferase (NNMT) that fat cells over-express when they become metabolically sluggish

You may also be at risk if you take certain medications, such as proton pump inhibitors (Nexium, Prilosec, Prevacid), histamine-2 receptor agonists (Pepcid and Zantac), and metformin for type 2 diabetes