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The latter arise from malabsorption from food-bound B12 induced by the hypochlorhydria associated with atrophic gastritis caused by the Helicobacter pylori, H pylori jnfection of the stomach (Sobczynska-Malefora et al., 2021)

excessive intake of vitamin B12 can potentially lead to nerve damage or disrupt the balance of other essential nutrients in the body

Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets [Posicin de la Asociacin estadounidense de dietistas y de los Dietistas de Canad: dietas vegetarianas] (pdf)

Placebo effects in low back pain: A systematic review and metaanalysis of the literature