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Other frequently associated drug classes include proton pump inhibitors (omeprazole, pantoprazole, lansoprazole), antifungals (terbinafine), oncologic agents (capecitabine, paclitaxel, docetaxel, tamoxifen, anastrozole, uracil-tegafur, leuprolide), tumor necrosis factor (TNF-) inhibitors, immune checkpoint inhibitors, and various others including leflunomide, lamotrigine, bupropion, ranitidine, and acebutolol

And Burl said, when in doubt, sending along a photo is always helpful

24 (1 Suppl 1): S1-71-S1-80

Some less common side effects are bumps, stiffness, discoloration, and burning

Vaessen N, Heutink P, Janssen JA, Witteman JCM, Testers L, Hofman A, Lamberts SWJ, Oostra BA, Pols HAP, Van Duijn CM

This includes: Pernicious anemia Crohns disease or celiac disease Gastric surgery or gastrointestinal disorders For mild deficiency, starting with 1,000 mcg of Vitamin B12 weekly is common