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~ AlphaMD Testicular atrophy, or shrinkage of the testes, can occur due to various factors, including long-term testosterone replacement therapy (TRT), anabolic steroid use, aging, and certain medical conditions

Clin Orthop Relat Res

Hormones: Its really common to hear about psoriasis showing up at the times hormones are changing: in puberty, pregnancy or during the menopause

Long-term, high-dose proton pump inhibitors may also affect B12 absorption in some patients

It is important to understand that discovering high B12 levels should prompt investigation into potential underlying causes rather than focusing solely on the elevated vitamin itself