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But several situations make it especially reasonable

Elevated zonulin levels have been found in patients with rheumatoid arthritis, multiple sclerosis or ankylosing spondylitis [1, 73,74,75]

Providers need secondary interventions that address this metabolic slowdown rather than simply forcing further appetite suppression

Common reasons for deficiency include: Low intake particularly diets low in whole grains, legumes, leafy greens or animal products Gut health issues like low stomach acid, SIBO, coeliac disease, IBD, or other factors affecting absorption Medications such as the contraceptive pill, metformin or antacids, which can deplete B vitamins Chronic stress increases demand for certain b vitamins, including B5 and B6 Vegan or vegetarian diets higher risk of B12 deficiency, which can be corrected through supplementation Genetic reasons some mutations on certain genes can increase a persons need for B vitamins This is why I always recommend testing before supplementing