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Calcium, the primary component of bone, is only properly absorbed by your body when vitamin D is present

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Pregnancy and breastfeeding are also contraindications due to insufficient safety data

In addition, a very fresh fecal smear (ideally sampled directly from the rectum) can be placed onto a slide with a drop of saline and looked at under the microscope to observe for movement (giardia may also be seen with this technique and look similar to tritrichomonas, however, tritrichomonas tend to wiggle forward, whereas giardia move in a swirling or 'falling-leaf' pattern)

When liver function is compromised due to excessive alcohol consumption, it can result in decreased levels of circulating iron and ultimately contribute to anemia

The use of PPIs is also thought to contribute to vitamin B12 deficiency (Aroda et al, 2016)