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A deficiency arises when the body fails to absorb sufficient B12 from food over prolonged periods

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Weight loss itself is a primary contributor : as body fat decreases, the body loses insulation and stored energy reserves

DOI: 10.1186/1550-2783-11-20

Other HDT agents, such as statins, are associated with muscle-related adverse effects (e.g., myopathy and rhabdomyolysis), especially at high doses or when used in combination with other medications metabolized by the cytochrome P450 system [152]

Given that the MEOS pathway for ethanol metabolism is induced in chronic alcoholics, the enhanced ethanol metabolism likely contributes to alcoholics metabolic tolerance for ethanol which in turn promotes further alcohol consumption