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The brain doesn't stop making neurotransmitters entirely, but the output is reduced, and the balance shifts in ways that can show up as anxiety, low mood, or both simultaneously
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Deficiency after gastric banding is therefore primarily related to: Reduced dietary intake and food tolerance , limiting consumption of B12-rich foods Use of acid-suppressing medicines (PPIs or H2RAs) , which can impair the release of B12 from food proteins and reduce absorption of food-bound B12 [4] Crystalline B12 — the form found in supplements and fortified foods — does not require acid or pepsin for release