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Common causes include: • Pernicious anemia, an autoimmune disorder hindering Vitamin B12 absorption • Gastrointestinal surgeries, like gastrectomy, impact Vitamin B12 uptake • Long-term use of certain medications, such as metformin or proton pump inhibitors • Diets lacking in Vitamin B12, often seen in vegans and vegetarians For those without a deficiency, Vitamin B12 injections are not typically recommended, as their body can naturally regulate and excrete excess amounts of the vitamin

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Support is available The first step in treating anabolic steroid dependency is to discontinue use and seek medical help