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Contraindications include Wilsons disease and hemochromatosis, both of which involve copper metabolism disorders

As mentioned above, spasm in the piriformis muscle can cause pain by squeezing against the sciatic nerve

It can also be depleted by chronic stress, alcohol, smoking, digestive issues, cardiovascular disease, illness, and aging because stomach acid production decreases with age, reducing B12 absorption significantly

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The condition is characterized by elevated anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin antibodies, lymphocytic infiltration of thyroid tissue, and gradual development of hypothyroidism